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ORDER.FRM
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1993-02-24
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Order Form for NOVMENU v2.0
----------------------------
P.O. Number (if required) : _____________
Company Name: ________________________________
Address : ____________________________________
____________________________________
City : __________________ Province/State/etc. : ______________
Country : __________________ Postal Code : ___________________
Contact Name : _____________________ Phone # : __________________
Media Prefrence : 5.25 [] 3.5 [] Fax # : ____________________
==================================================================
Canadian orders are in CDN. funds all other orders are in US funds
Qty. Range Qty. Required Unit Price Cost
---------- -------------- ----------- -----
1 - 5 -------- $29.95 $__________
6 - 20 -------- $26.95 $__________
21 - 50 -------- $24.95 $__________
51 - 100 -------- $21.95 $__________
101 - 500 -------- $19.95 $__________
501 - 1000 -------- $16.95 $__________
1001 - 1500 -------- $14.95 $__________
> 1501 Please call (416) 467-0294
Canadian Residents add 7% GST $__________
Ontario Residents add 8% PST $__________
TOTAL COST $__________
Please send this page and a cheque or money order for the above
amount to:
BRIT Technologies Inc.
613 Glebeholme Blvd.
Toronto, Ontario
M4C 1V5 Canada 416-467-0294