Order Form For Canadian Residents only. contact information and mailing address Last Name: First Name: Name of Business: Mailing Address: City: Province / State: Country: Postal / Zip Code: Home# Area Code: Number: Work# Area Code: Number: E-mail Address: Preferred method of communication: .................................................................................. E-mail Telephone (Home) Telephone (Work) Fax (Home) Fax (Work) products you wish to order videos: .................................................................................. Meridian Shiatsu $15 + $0.90 gst + $7 S&H = $22.90 out of stock Shiatsu Stretching $25 + $1.50 gst + $7 S&H = $33.50 out of stock Meridian Shiatsu & Shiatsu Stretching $50 + $3.00 gst + $11 S&H = $64.00 none Subtotal A Shipping & Handling (10% X A) B (Minimum $5.00) Subtotal (A+B) C Add gst (7% X C) D TOTAL Method of Payment: .................................................................................. Visa MasterCard Card Number: Expiration Date: If you do not feel comfortable giving your credit card information over the internet please do one of the following: Type FAX beside "Method of Payment". Submit form and fax your credit card information to (416) 323-1681. or Type PHONE beside "Method of Payment". Submit form and phone us with your credit card information at (416) 323-1818 (local) or toll-free (800) 263-1703 If you do not have a VISA or MasterCard please do not send a personal cheque or cash: Type N/A beside "Method of Payment". Submit form and we will contact you regarding an alternative method of payment. Please allow 4-6 weeks for delivery.
Order Form
For Canadian Residents only.
contact information and mailing address
Last Name: First Name: Name of Business: Mailing Address: City: Province / State: Country: Postal / Zip Code: Home# Area Code: Number: Work# Area Code: Number:
E-mail Address:
Preferred method of communication: .................................................................................. E-mail Telephone (Home) Telephone (Work) Fax (Home) Fax (Work)
products you wish to order
videos:
.................................................................................. Meridian Shiatsu $15 + $0.90 gst + $7 S&H = $22.90 out of stock Shiatsu Stretching $25 + $1.50 gst + $7 S&H = $33.50 out of stock Meridian Shiatsu & Shiatsu Stretching $50 + $3.00 gst + $11 S&H = $64.00 none
Subtotal A Shipping & Handling (10% X A) B (Minimum $5.00) Subtotal (A+B) C
Add gst (7% X C) D
TOTAL
Method of Payment: .................................................................................. Visa MasterCard
Card Number: Expiration Date: If you do not feel comfortable giving your credit card information over the internet please do one of the following: Type FAX beside "Method of Payment". Submit form and fax your credit card information to (416) 323-1681. or Type PHONE beside "Method of Payment". Submit form and phone us with your credit card information at (416) 323-1818 (local) or toll-free (800) 263-1703
If you do not have a VISA or MasterCard please do not send a personal cheque or cash:
Type N/A beside "Method of Payment". Submit form and we will contact you regarding an alternative method of payment.
Please allow 4-6 weeks for delivery.
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