You can use this online form to begin the order process. Simply complete this form and a customer representative will contact you to confirm the information, arrange payment and shipping. Fields marked with a * are required.
If you would prefer to fax your order, please click on the PRINTABLE FORM below. Print the form, fill it out by hand and fax it to us at (905) 794-2338. Please include your phone number so we can contact you and review the order.
Customer
Information
*Purchaser Name:
*Company/Organization:
*Address:
Address:
*City:
*Country:
*Phone:
*Fax:
*Email:
*Postal/Zip Code:
PO#:
Order Information
Product
Quantity
Unit Price
Subtotal
1.
$
$
2.
$
$
3.
$
$
Total
$
Note:
Taxes are dependant on origin of purchaser and will be determined during
the order confirmation. Minimum order for some items. Please refer to
the Price List.
Shipping Information
Check if shipping address is the same as above.
Attention:
Company/Organization:
Address:
Address:
City:
Country:
Postal/Zip Code:
*Date Required:
Note:
Cost of shipping will be determined and then authorized by the purchaser
during the order confirmation.
