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| Circle payment method: Cheque | Bank Transfer | Mastercard | Visa | | |
| Number | Expiration |
| QUANTITY | PRODUCT # | DESCRIPTION | PRICE EACH | TOTAL |
| SUBTOTAL | ||||
| Packing &
Postage |
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| ORDER TOTAL | ||||
For orders, please print order sheet, fill out and fax to above no. Any change to web prices or postage above $10.00 will be confirmed before dispatch.