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ORDER FORM

Please fill out the form, print, sign and fax to us at (905) 470-7166

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Ship To: same as the above or

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Address

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Order Information:

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Sales taxes and Shipping charge will be added to total charges where applicable.

Payment: VISA Master Card Amex
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Signature_______________________     (Please print form, sign & fax to 905-470-7166)