Debmar Distributing Inc. - Print Out Order Form

To Order By Fax Or Mail Please Print This Form

Mail to: Debmar Distributing Inc., 17 Wexford Road, Brampton, Ontario CDA L6Z 2V9

Fax To: 905 846-5689

SHIPPING ADDRESS Please complete all details	BILLING ADDRESS if you are paying by credit card.
Name	Name
Company	Company
Address	Address

City	City
Province/State	Province/State
Country	Country
Postal/Zip Code	Postal/Zip Code
Phone#	Phone#

Charge my: Visa Card____ Mastercard____ Amex____

Credit Card #_________________________________Expiry Date___________

Signature:____________________________________

Certified Cheque Enclosed_____(if sending by mail)
Money Order Enclosed____ (if sending by mail)

	ITEM #	QUANTITY	DESCRIPTION	PRICE EACH	TOTAL
1.
2.
3.
4.
5.
6.
				FREIGHT
				GST*
				PST**

				TOTAL

Thank You For Your Order!

*Canadian Residents Add 7% GST **Ontario Residents also Add 8% PST

U.S. Dollars outside of Canada.

SHIPPING RATES FOR NORTH AMERICA

Ground Shipments (2-10 Business Days)..................................$15.00 + gst

Express (1-3 Business Days)..............................................................$30.00 + gst

Next Day Delivery.....................................................................Call 1-800-265-3354 or E-Mail customerservice@debmar.com for Rate

SHIPPING RATES OUTSIDE NORTH AMERICA

Call 1-800-265-3354 or E-Mail customerservice@debmar.com for Rate