BRENDA FRANKLIN

ORDER FORM

DATE____________________________ NAME ___________________________ STREET__________________________ CITY____________________________ PROVINCE/STATE _________________ POSTAL/ZIP CODE____________________________ PHONE #__________________________ EMAIL ADDRESS_________________________				MAIL/PHONE OR FAX ORDERS TO: Brenda Franklin R.R. 1 Alma, Ontario Canada, N0B 1A0 Phone/Fax: (519) 638-9958 WEB SITE AND E-MAIL IS NOT SECURE *Answering machine accepts faxes*
QUANTITY	PATTERN #	DESCRIPTION					PRICE	TOTAL
METHOD OF PAYMENT CHECK ____________ Mastercard_________ Visa_________ Card#________________________________Expiry Date________ Signature________________________________________________ *Signature required for all credit card orders * NO POSTAL MONEY ORDERS PLEASE PLEASE MAKE CHECK PAYABLE TO BRENDA FRANKLIN					SUBTOTAL SHIPPING SUBTOTAL ONTARIO RESIDENTS. ADD 8% - NO GST
					TOTAL
U.S. CUSTOMERS ORDERS UP TO $20.00 ADD $3.00 $20.01 TO $50.00 ADD $4.00 $50.01 TO 100.00 ADD $6.00 $100.01 + ADD $10.00			CANADIAN CUSTOMERS ORDERS UP TO $2O.00 ADD $2.00 $20.01 TO $50.00 ADD $3.00 $50.01 TO 100.00 ADD $5.00 $100.01 + ADD $10.00			FOREIGN CUSTOMERS ORDERS UP TO $20.00 ADD $4.50 $20.01 TO $50.00 ADD $7.00 $50.01 TO 100.00 ADD $13.00 $100.01 + ADD $20.00

ALL SALES ARE FINAL

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MAIL & FAX ORDER FORM

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