Pheylonian Beeswax Candles - Retail Order Form

PHEYLONIAN PRODUCTION KOHR.

RETAIL ORDER FORM

Name:_________________________________________________		Date:___________
Address:_________________________________	City:___________	Prov/State:_____
PC/ZIP:__________ PH:____________________ FX:____________________

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Payment	Sub Total	.
[ ] Visa [ ] MC [ ] Check/Money Order	P.S.T. (8%)	.
Chrg. Acct. # ___________________________ Exp: _______	G.S.T. (7%)	.
Signature: ________________________________	Shipping	*14.95
Ship By: __ UPS __Can par __Mail	Handling	2.50
[ ] Quote Email:	Total

You're welcome to print and fill out this for and fax or mail it to us, don't forget to read the terms. Terms can change depending on your location and type of order.

* Normal standard freight charges applies to orders placed in North America only and are subject to change. Freight charges for all other locations will be advised at time of receipt of order.

Fax: 613-478-5410 Email: sales@philoxia.com

Mail to: Pheylonian Production Kohr

PO BOX 56

Marlbank Ontario

K0K2L0 Canada