Company Name

Operating As

Mailing Address

City

Province

Postal Code

Main Phone Number

Fax Number

Tell us about your business

80 characters or less

Ship to:

If different from billing address

PO Required

GST Exempt

If selected yes:

GST #

PST Exempt

Invoice Email


Set Up Online Ordering: 

Purchaser Name

Title/ Department

Purchaser Email

This email will be used for your username

Additional Comments

Terms and Conditions: 

We can process Visa, Mastercard and American Express payments upon shipping of your order. Qualified charge accounts are Net 30 days with interest charged at 2% per month (24% per annum) on overdue balances. NSF cheques are subject to immediate reimbursement plus a NSF Fee of $25. Credit privileges may be cancelled with no advance notice.

Do you agree to the terms & conditions?

Name/ Title

Date

Accounts can take 1-2 business days to be active online. If you would like to make a purchase in the meantime, please contact us.