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| 1. PURCHASER INFORMATION | |||||||||
| Contact name/purchaser | Company/organization | ||||||||
| Shipping address | |||||||||
| Business address | |||||||||
| Telephone no. | Facsimile no. | E-mail address | |||||||
| 2. PAYMENT METHOD | |||||||||
| Credit card | |||||||||
| Cheque/money order | Request for quotation/pro forma | ||||||||
| MasterCard or VISA or AMERICAN EXPRESS no. |
Expiry date |
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| 3. ORDER INFORMATION | |||||||||
| Name of Reference Material |
# of Units |
Unit Cost ($CAD) |
Total Cost ($CAD) |
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| Transaction fees: Rush order $50 CAD | |||||||||
| Total cost of reference materials (applicable taxes extra) | |||||||||
| Purchase order no. (if applicable) |
GST or PST exemption no. (if applicable) |
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| Shipping Charges: Purchaser to provide: Courier company Courier account no. OR Include shipping charges on invoice |
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| 4. SPECIAL SHIPPING INSTRUCTIONS |
Please send orders to: Sales Officer, CCRMP |
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