Citywireless.ca Mail/Fax Order Form
|
| Ship to: |
| Name:_________________________________________ |
| Address:_______________________________________ |
| City/State/Zip:___________________________________ |
| Country:_______________________________________ |
| Phone:
_______________________________________ |
|
| E-Mail Address
(optional) |
| ______________________ |
| Used to send order shipment notifications.
|
| |
|
Product Name &
Product ID
|
Price Each
|
Qty.
|
Total
|
| |____________________________________ |
|_______ |
|_______ |
|_______
|
| |____________________________________ |
|_______ |
|_______ |
|_______ |
| |____________________________________ |
|_______ |
|_______ |
|_______ |
| |____________________________________ |
|_______ |
|_______ |
|_______ |
| |____________________________________ |
|_______ |
|_______ |
|_______ |
| |____________________________________ |
|_______ |
|_______ |
|_______ |
| |___________________________________ |
|_______ |
|_______ |
|_______ |
| |___________________________________ |
|_______ |
|_______ |
|_______ |
| |___________________________________ |
|_______ |
|_______ |
|_______ |
| |___________________________________ |
|_______ |
|_______ |
|_______ |
|
Shipping Method: Expedited
XpresspostOvernight
|
Subtotal |
|_______ |
| Shipping Cost:
|
|_______ |
| GST/HST:
|
|_______ |
| Total |
|_______ |
| For Money Order, Payable To: Citywireless.ca |
|
| Signature:_________________________________ |
|
|
| Mail to: |
|
| Citywireless.ca |
| 1 Waringstown Dr |
| Toronto, ON |
| M1R 4H2 |
| Canada |
|