Please
print form, fill-out by hand and mail or fax it to:
Ear
Curls, etc.:
4840 Cutlass Ct., Pender Is., BC, Canada, V0N 2M2
Fax: (250) 629-6560
|
Quantity
|
Product
Code
|
Bead
Code
|
Price
|
Total
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cheque
or Money order enclosed ___
|
Shipping
and Handling
Western Canada: $8
Others: $10
|
|
|
Allow
7 days for cheques to clear.
|
Sub-total
|
|
|
Please
make cheques payable to :
Ear Curls, etc.
|
Within
Canada: 5% GST
|
|
|
Please
charge to:
Visa ___ # _________________________
Mastercard ___ # ____________________
|
B.C.
Residents add 7% PST
|
|
Expiry
Date: ____ / ____
Cardholder Signature:
__________________
|
Total:
|
|
| Sold
to:
Name:
__________________
Address: ________________
City: ___________________
Postal Code: _____________
Country: ________________
Phone: ______________ Fax: _______
email: __________________________
|
Mail
to (if different address):
Name:
__________________
Address: ________________
City: ___________________
Postal Code: _____________
Country: ________________
|
| Special
Requests: |