ORDER FORM
PLEASE PRINT A COPY
FILL OUT AND FAX TO 705-327-5281

Payment may be made by Visa, Mastercard, American Express, Cheque or Money Order.
Credit terms available to approved accounts.

PLEASE NOTE: MINIMUM ORDER $150.00 PLUS SHIPPING

Shipping Charges and Taxes are extra.


Name.................................................................Company.............................................................................................

Street Address or Mailing Address...................................................................................................................

City..........................................................................State/Province.................................Zip/Postal Code................................

Telephone No.....................................Fax No..................................Email.........................................................

Payment method (circle) ........... Visa.......... Amex...... Cheque.......... P.O. No..................................

Card No...................................................................Security Code.................... Expiry........................

Cardholder's Name........................................................................................................................

Please list items you wish to order
Part No.	Description	Quantity	Unit Price	Total
			TOTAL

Signature......................................................................................
 
UPDATED MAY 2019