Order Form                              

Print this form and mail or fax to:

Maternal Source
134 Highbury Place
Saskatoon, SK Canada
S7H 4X7

Please provide the following contact information:

CONTACT INFORMATION

Name

Business or Organization

Street Address

City   Province or State

Country Postal Code or Zip

Phone

FAX

E-mail

SHIPPING (if different than above)

Street Address

City   Province or State

Country Postal Code or Zip

BILLING

Specify method of payment

 

Cardholder Name

Card Number

Expiration Date

ORDER

Please provide the following ordering information:

QTY PRODUCT SKU OR DESCRIPTION

An email will be sent to you stating the exact pricing of your products, plus Shipping and Handling Charges.

 

 Saskatchewan residents ONLY add 5% PST on all orders except books and children's clothing

Last update: Tuesday September 14, 2010                                                                                                                                                 Copyright ©2003-2010 Maternal Source