Product Order Form

Please use this form to submit a product order via web, filling in as much detail as possible. Be sure to provide us with a contact name and phone number as we may need to clarify your order.

Contact Information:

Name

Pickup date / Date Required

E-mail

Phone

Product Order

Quantity (incl. units)	Description	Price

Method of Delivery:

Ship to:

Pick-up

please include full shipping address:

please indicate which of our retail stores you will be picking up your order from:

Method of Payment:


Visa	Mastercard	Interac Email Transfer	In-store Payment (Cash, Debit)
Please contact us at (604) 437-8221 during regular business hours to provide your credit card information or make arrangements for Interac email transfers (orders will not be processed until payment information has been received).