PRODUCT ORDER FORM
NAME:
OLD EUROPE DUVET COMPANY
P.O. Box 237, Milton, ON, Canada
L9T 4N9
Phone: (905) 878-5782
Fax: (905) 875-0613
SHIPPING ADDRESS:
POSTAL CODE: PHONE #:
FAX #:
EMAIL ADDRESS:

METHOD OF PAYMENT (Full payment in Canadian dollars must accompany order)

CHEQUE /MONEY ORDER
MASTERCARD /VISA		 CARD #:
NAME OF CARD HOLDER:
 EXPIRY DATE:


ITEM DESCRIPTION
(include all pertinent information - model, size,fill, etc.)		 UNIT PRICE QUANTITY TOTAL
1. $ $
2. $ $
3. $ $
4. $ $
5. $ $
Shipping Costs (for details see previous page)
DESTINATION Per Duvet 1 Pillow 2 Pillows
Canada $19 $10 $15
Continental
U.S.		 $36 $15 $25
All Others $95 $39 $65
Sales Tax
PST- Ontario residents please add 8% of sub-total
GST - Canadian residents please add 5% of sub-total
SHIPPING $
SUB-TOTAL $
8% ONTARIO PST $
5% CANADIAN GST $
TOTAL AMOUNT ENCLOSED (CDN$) $

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Email | Fax | Telephone

Optional Questions

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