Fax/Mail Order Form

 

   RITA M. STAMP
188 King Edward Avenue
East York, Ontario
Canada   M4C5J8

Pre-Order Form

Please note that "R.E.A.L." is still in the publishing stages and has not yet been sent to print. This form is available if you would like to pre-order your copy. We will notify you via e-mail when the book becomes available for sale.

 

 
Date:  
Phone No:
Fax No: E-Mail:  
Order Placed by:   Phone Fax: Regular Mail

Account Info:
VISA # (or) Master Card  (Circle one)

Expiry Date:  
Business Name (or) Name on Card:
 
Mailing Address  

City   Province / State
Postal / Zip Code Country

Quantity

Description of Item

Unit Cost

 

 

 
     
     
     
     
                                                           Subtotal  
                                                           Shipping Charges  
                                                           Taxable Subtotal  
                                                           Total Amount: $
     

 Thank You!