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| Fax back to: (604) 298-9051 | - Fax Order - |
(Please print clearly) |
| Name: | ||||
| Company Name: | ||||
| Address: | ||||
| City: | State: | |||
| Postal Code: | Country: | |||
| Telephone: | Fax: | |||
| E-mail : | ||||
| Payment | VISA | Master Card | American Express | T/T |
| Credit Card Number: | Exp. date: | |||
| Name on card: | ||||
| Billing Address: | ||||
| Billing Telephone | Shipping Telephone: | |||
| Shipping Method: | Courier Account # (optional): | |||
Please fill in items you want to order. Leave price and shipping blank if you don't know them. We will fax/e-mail the quotes back to you.
| Model | Descriptions | Qty. | Price |
| Please calculate the total and fill it here: | |||
| Shipping Charge: | |||
| HST 12% (if ordering inside Canada): | |||
| Subtotal: | |||
| Special Requests: |
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Signature: |
Date: | ||
| Cavision Enterprises Ltd Tel: 604-298-9053 Fax: 604-298-9051 E-Mail: info@cavision.com |