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KING MEDICAL LTD. |
order
form |
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The Canadian Electrode Place |
Please print this form and fill out |
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Your information will
not be stored electronically |
To print this form: Right click
• Click Select All •
Print |
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Bill To: [Please
PRINT] |
Ship To: [Please PRINT] |
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Name |
Name |
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Address |
Address |
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Phone |
Phone |
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Fax |
Fax |
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e-mail |
e-mail |
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Order # |
Description |
Qty. |
Price |
Ext. Price |
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► All mentioned prices are in Can$ • FOB King
City, Ontario |
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► Applicable taxes will be added for Canadian
customers. |
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► Freight UPS Expedited (you pay less than
UPS Standard) will be prepaid and added to invoice. |
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Please |
• FAX order form to |
905-833-3543 All fax orders will be confirmed. |
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CALL us on |
905-833-3545 |
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• MaiL
order form to |
King
Medical Ltd. |
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