We Ship Worldwide
NO TAX on Orders Shipped Outside of CANADA!!

FAX ORDER FORM

Please Complete Order Information Fully;
then PRINT and FAX to: 306-931-4455

Billing Information
 
*First Name 
*Last Name 
*Address 1 
Address 2 
*City 
*Province/State  *Postal/Zip Code  
*Country
*Telephone 
Fax 
Billing/Admin Email 
 
* All marked fields must be completed.
* To process your credit card order, the Billing Address supplied must match the address to which the credit card statement is mailed.
 
Ship To Same As Above, or:
 
First Name 
Last Name 
Address 1 
Address 2 
City 
Province/State  Postal/Zip Code  
Country
Telephone 
Fax 
Receiver's Email 

 

Please Include Quantity, Item Number, Description and Cost
Qty Item # Product Price

ADDITIONAL COMMENTS:

 

 

Credit Card: Mastercard or VISA only
Card Number:
Expiry Date: / (MM/YY)
Name on Card:
Cardholders Phone Number:
All Credit Information Is Mandatory
To process your credit card order, the Billing Address supplied must match the address to which the credit card statement is mailed.

We will contact you at the phone number provided if we require more information.