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Text File  |  1993-01-27  |  1KB  |  33 lines
  1. THE MINI VAC ORDER FORM
  2. ------------------------------------------------------------------------
  3.  
  4. NAME:_______________________________________
  5.  
  6. ADDRESS:___________________________________________________
  7.  
  8. CITY, STATE, POSTAL CODE:_____________________________________________
  9.  
  10. TELEPHONE NUMBER:____________________________________________
  11.                  (In case we have questions about your order)
  12.  
  13. PLEASE SEND ME [_____] MINI VAC'S AT $19.95 + $4.60 Ship. & Hand. / Order
  14. * Payment by cheque or money-order: payable to Batson Distributing *
  15.  
  16.  
  17.                      SUB-TOTAL           :
  18.                      ($19.95 * QUANTITY)
  19.  
  20.                      Shipping & Handling :
  21.                      ($4.60 * QUANTITY)
  22.                                           ==============
  23.                      GRAND TOTAL         :
  24. -------------------------------------------------------------------------
  25. Mailing Address:
  26. BATSON DISTRIBUTING
  27. 589 MIDDLEFIELD RD. UNIT #26
  28. SCARBOROUGH, ONTARIO
  29. M1V 4Y6
  30. FAX: (416) 396-5545
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