Canadian residents only: |
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Please send me the items listed below. | ||||||
QTY | CODE | TITLE | PRICE+ | |||
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SUB-TOTAL | ||||||
Quebec & Ontario $7.50 | ||||||
TOTAL | ||||||
I will pay the total amount by Check ___ Money Order ___ Credit Card: ___ VISA ___ MASTERCARD ___ AMERICAN EXPRESS Card # ________________________________________ Expiry Date ____________ Signature _______________________________________ Name ______________________________________________________ Address _______________________________________________________________ ___________________________________ City _______________________________ Province _____________________________ Postal Code ______________________ Tel. (_____)_________________________ Fax (_____)_______________________ E-mail ___________________________________________________ | ||||||
Please note that orders payable by check or money order will be shipped | ||||||
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