|
Please complete all applicable fields:
| Ship to: |
|
| Street Address: |
|
| City, State, Zip |
|
| Country |
|
| Tel: |
|
| Fax: |
|
| email Address: |
|
| DDS Serial No: |
|
|
Quantity |
Item Description |
Price |
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
|
Shipping & Handling: |
Internet Download Only
|
|
SUBTOTAL: |
|
|
GST - 7 % of subtotal
(Canadian Residents Only )
Business No: 13190 5739 RT0001
|
|
|
PST - 8% of subtotal
(Ontario Residents Only ) |
|
|
TOTAL:
Please make cheques/money
orders payable to:
Dunfield Development Services Inc.
|
|
|
 |
 |
| Please print out this form and:
Mail to:
Dunfield Development Services Inc.
115 Manion Heights Cr. RR 2 Carp, ON K0A 1L0 CANADA
OR
Fax to: 613-256-5821
|
|
 |
|
|