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Product
Code |
Description | Quantity |
Price |
Amount |
| ____________ | _________________________________ | _______ | _______ | |
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| ____________ | _________________________________ | _______ | _______ | |
| ____________ | _________________________________ | _______ | _______ |
| ____________ | _________________________________ | _______ | _______ | |
| ____________ | _________________________________ | _______ | _______ | |
| ____________ | _________________________________ | _______ | _______ | |
| ____________ | _________________________________ | _______ | _______ | |
| ____________ | _________________________________ | _______ | _______ | |
| ____________ | _________________________________ | _______ | _______ |
SUBTOTAL |
_________________ |
|
GST: |
_________________ | |
TOTAL: |
_________________ |
| VISA | MASTERCARD
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CHEQUE
OR MONEY ORDER
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| # (expiry date) _______________________________ | # (expiry date) _______________________________ |
| SHIPPING
ADDRESS |
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| CONTACT
NAME |
|
PHONE: |
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EMAIL: |
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FAX: |
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Print
this order form and mail to: Three Hearts & Company 1603-7 Ave. South Lethbridge, AB, Canada T1J 1L7 |
If
you have any questions please Phone
(403) 329-9356 - Fax (403) 328-1851 |