Canes Canada Online Order Form

For our customers who would rather send in an order form rather than use our web store, please fill in the proper product identity number. Then print this form using the browser print button and mail it to us with payment by money order or money transfer (Western Union). Sorry, we don't accept personal cheques.

Please provide the following contact information:

Name

Address

City

Province/State

Postal/Zip Code

Phone

Email

BILLING

Credit Card

Cardholder Name

Card Number

Expiration Date

Phone

SHIPPING (if different from above)

Name

Street Address

Address (cont.)

City

Province/State

Postal Code/Zip

Country

Phone

Special Instructions?

Please provide the following ordering information:
(All prices are in Canadian dollars.)

Qty Product # Description Cost Each Total

Shipping and Handling - call for rates

Sub Total

Total

Signature of Purchaser

Canes Canada Inc.
Box #1355, 246 Stewart Green SW
Calgary, Alberta, Canada T3H 3C8

Phone: 1-866-217-8091
FAX: 403-240-2597

Name
Address
City
Province/State
Postal/Zip Code
Phone
Email

	BILLING
Credit Card
Cardholder Name
Card Number
Expiration Date
Phone

	SHIPPING (if different from above)
Name
Street Address
Address (cont.)
City
Province/State
Postal Code/Zip
Country
Phone

Qty	Product #	Description	Cost Each	Total





Shipping and Handling - call for rates
Sub Total
Total
Signature of Purchaser