FAX OR MAIL ORDER FORM - USA Only  
To make an order, please fill out and print the form below.
A customer service representative will contact you when your order ships.
All orders shipped to USA are free of all Canadian taxes.
Product Code Product Name/Description Price Quantity
ITEM 1   
ITEM 2   
ITEM 3   
ITEM 4   
ITEM 5   
ITEM 6   
ITEM 7   
ITEM 8   
ITEM 9   
ITEM 10 
Personal Information
Your Name: Daytime Phone:*
Company Name: Evening Phone:*
Email Address: Fax:*
(*please include area code)
Billing Information: Shipping Information: (if different than billing address)
Address:
Address 2:
City:
State:
Country: ZIP:   
Address:
Address 2:
City:
State:
Country: Zip:   
Method of Shipping:
Canada Post/United States Postal Service **
 Xpresspost/Priority Mail (6 business days)
Expedited Parcel (10 business days)

** This is the most economical means for shipping parcels. UPS charges will typically be 4 or 5 times more than that of the post office. 		UPS
Due to the very high cost of UPS on cross-border shipments, we only offer this service on very large shipments. Call for details.
Payment Information
Credit Card: VISA   MasterCard
Credit Card Number: CCID:  what's this? Expiry Date:
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