Place an order with us

To facilitate your order, this page has been opened up as a separate window.
Re size as required

Please use this form to send us an Order.  It will be electronically and securely transmitted to us.  We will respond, usually the same day, to confirm the order, and discuss pricing, delivery, etc.  Please note that we do not accept credit cards at this time.  Thank-you.

Order Processing Date: @

Company Name:

Company Address:                                        City:
  
Prov/State:                       Country                             Postal/Zip Code
    
Your Name:                                  Your Email Address:
 
Telephone:                                    Facsimile:
 
Your P.O No:                  Tag:                                           Date Req'd:
   
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Quantity:            Item No:                     Description:
   
   
   
   
   
   
   
   
   
   
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Enter additional comments in the space below:

Select one of the following ways for us to confirm your order:

E-MAIL or, TELEPHONE or, FAX

    

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