Enter billing information
below:
Enter shipping address
Name
___________________________________
Name
_______________________________________
Address ____________________________________ Address ________________________________________
City _______________________________________ City ___________________________________________
Province/State, Postal/Zip Code __________________ Province/State, Postal/Zip Code ______________________
Phone ___________________________________ Phone _______________________________________
Email Address
________________________________
Email Address ____________________________________
|
Item No.* |
Item Description |
Size / Color |
Quantity |
X | Price |
= |
Total Cost |
| _______ |
____________________________ |
__________ | ______ | X | ______ | = | ________ |
| ________ | ________________________________ | __________ | ______ | X | ______ | = | ________ |
| ________ | ________________________________ | __________ | ______ | X | ______ | = | ________ |
| ________ | ________________________________ | __________ | ______ | X | ______ | = | ________ |
| ________ | ________________________________ | __________ | ______ | X | ______ | = | ________ |
| ________ | ________________________________ | __________ | ______ | X | ______ | = | ________ |
| ________ | ________________________________ | __________ | ______ | X | ______ | = | ________ |
| ________ | ________________________________ | __________ | ______ | X | ______ | = | ________ |
| ________ | ________________________________ | __________ | ______ | X | ______ | = | ________ |
If you run out of space please write the rest of your order on the back.
| SHIPPING & HANDLING
Canada If your order is: $1 - $20......................Actual + $2 $20.01 - $50......................$5.50 $50.01 - $99.99......................$8.00 $100.00 plus.................FREE U.S. $1 - $20......................Actual + $2 $20.01-$40.00.................$9.00 CAD $40.01-$149.99................$12.00 CAD $150 Plus................FREE Tax and shipping are calculated on the total amount of merchandise ordered.
If your order is $20 or less please email telling us what you ordered & your postal code or state. We'll email you the shipping charge. |
Subtotal (from above) ________ Shipping Cost (from
left) ________
Ecoupon ________
Canadians TOTAL COST
________
Gift Certifiate/Ecoupon Claim Code _______________________ |
*Leave blank if item number not shown.
Methods of Payment
| Card Number | Exp. Date | Signature | Cardholder's Name |
| ____________________ | ______ | ________________________ | ________________________ |
Gift orders - if you'd like a message included please write it below (or we'll include a note that the gift is from you). Question? See FAQs
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