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ORDER FORM
CONTACT INFORMATION
* To use - You must have an Email Account set up on your computer (ex. Outlook Express) -
if no email on your computer, still click the Print & Email button and you can fax the order
Toll Free to 1-877-524-6500
We will then reply to your Email, confirming receipt of your order.

*Company Name: required field *
*Contact Name:
E-mail:
  *Phone:     Fax:
*Shipping Address:
 
 
 
  New Customer:      Current Customer: Account Code:
  Billing Address Is Same As Shipping?
Billing Address:
(if different than shipping)
 
 
  Payment information on file    Will phone with information
  Please phone 1(306)652-2112 or fax 1(306)653-4334 with payment details
 
ITEM # - Quantity - Description - Price Comments

Type Order Here

Then Click On The
Print & Email Button
At Bottom Of Page

Follow directions
from your printer and
email program

 
  
 


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