Northern Tech Diver.com Printable Order Form

Date:_____________

To Fax a order to NorthernTechDiver.com, simply print this form using your Browser. Completely fill out the form and fax to (613) 634-8135 .

Orders may also be sent via Regular Mail to:

Northern Tech Diver
4052 Bath Rd
Kingston, Ontario, Canada
K7M 4Y4

Attn: Order Dept.

Customer Information
First name ________________________
Last name ________________________
Street address ________________________
City ________________________ State/Province_____________
Zip/Postal code ________________________ Country __________________
Work Phone ________________________ Home Phone_______________
E-mail ________________________
Please provide the following product information.

QTY 

PRODUCT NAME

DESCRIPTION PRICE
______ __________________ _______________________________ ___________
______ __________________ _______________________________ ___________
______ __________________ _______________________________ ___________
______ __________________ _______________________________ ___________
______ __________________ _______________________________ ___________

 

 

 

 

 


                                                                                                       TOTAL __________
Shipping & Handling (Shipping charges will be calculated on receipt of order)  __________ 
                                                     Ontario residence add 8% sales tax + 7% GST __________       

                                                                                                  Grand Total __________

BILLING INFORMATION      Note:  We only ship to the billing address.
Credit card Visa, MasterCard, AMEX  (Circle One)

Cardholder name

______________________

Card number

______________________

Expiration date

______________________
Street address ___________________
City ___________________ State/Province__________ 
Zip/Postal code ___________________ Country_______________  

Comments Or Special Instructions:

 

 

Printable Order Form Instructions:

1) Print this form using your Browsers Print Feature.

2) Fill the form out completely.

3) Either Fax or Mail the form to us. ( The fax number and address are at the top of this page).

4) If you are paying by check or money order... Send payment to the address above. Note: We cannot process your order until payment is received. Upon receipt of your order we will send you a detailed invoice that includes all products and shipping and handling.


Thank you for shopping NorthernTechDiver.com, we look forward to serving you in the future.

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