| 
MAIL       
 ORDER ONLY  | 
 900 Napanee Rd. Marlbank, Ontario K0K 2L0  | 
        MINIMUM
 ORDER $60  | 
| Shipping Only In Canada | 
| TO: _________________________________________ DATE: _______ | 
| Street/P.O. Box or R.R.# ______________________________________ | 
| City/Town: _________________Prov. ________Postal Code__________ | 
| Email Address:___________________ Telephone # ________________ | 
| QTY. | NAME | EACH | TOTAL | 
| 
Pick up orders - 5% Handling State Preferred Date April 28 or 29, May 5 or 6 Post & Pack Up to $250, add $25 $250-$500, add 10% Over $500, add $50  | 
Total | |
| 8% Ont. Tax | ||
| 
Post & Pack or Pick Up  | 
||
| TOTAL ENCLOSED |