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KING MEDICAL LTD. |
order form |
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The Canadian Electrode Place |
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Please print this form and fill out To
print this form: Right click • Click
Select All • Print |
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Bill to: (Please PRINT) |
Ship to: (Please fill out, if different from Bill to) |
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Name |
Name |
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Address |
Address |
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Phone |
Fax |
Phone |
Fax |
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e-mail |
e-mail |
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Your information will not be
stored electronically Or
call us with the number! |
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Order # |
Description |
Qty. |
Price |
Total |
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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 (but 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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