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ORDERED BY: Name _________________________________ Address ______________________________ City ______________ Province/State___ Postal Code/Zip____________ Phone________________E-mail________________ SHIP TO:(If different than ordered by) Name _________________________________ Address ______________________________ City ______________ Province/State___ Postal Code/Zip______ Phone___________E-mail___________
PAYMENT INFORMATION - Address cheques to "THE MAGICAL BLEND" [ ] Check enclosed [ ] Money Order [ ] Credit Card (MasterCard or Visa)
[ ] MasterCard [ ] Visa
Card Number _____________________________
Expiry Date: _____/_____
Name On Card ____________________________
Signature _______________________________
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___ITEM#___|SIZE|__COLOR__|________DESCRIPTION________|QTY|_UNIT$_|___TOTAL__
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Subtotal |
|__________
Quebec Residents add 7.5% Sales Tax |
|__________
Canadian Residents add 7% Sales Tax |
|__________
Shipping and Handling (see below) |
|__________
Total |
|__________
______________________________
SHIPPING and HANDLING
______________________________
$15.00 or less | Add $4.70
_______________|______________
$15.01 $30.00 | Add $7.70
_______________|______________
$30.01 $50.00 | Add $10.70
_______________|______________
$50.01 $75.00 | Add $13.70
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$75.01 and more| Add $16.70
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