Online Order Form
Customer Information:
Name:
Company Name:
Vendor's Permit No.
Address:
City:
Province/State:
Country:
Postal/Zip Code:
Phone:
Fax:
Email:
Order Items
Item Number
Qty
Cost
Total
GDH-013
$4.00 EA
GDH-015 ORG
$4.00 EA
GDH-015 BEIGE
$4.00 EA
GLX-0013 BLUE
$5.00 EA
GLX-001 PUR
$5.00 EA
GLX-002 BLK
$5.00 EA
GLX-004 BEIGE
$5.00 EA
GLX-005 PINK
$5.00 EA
GLX-006 GRN
$5.00 EA
GLX-007 RED
$5.00 EA
GLX-008
$5.50 EA
GLX-009
$5.50 EA
GLX-010
$5.50 EA
GLX-011
$5.50 EA
GLX-012
$5.50 EA
GLX-013
$5.50 EA
GLX-014
$5.50 EA
GLX-015
$2.75 EA
GLX-016
$2.75 EA
GLX-017
$2.75 EA
GLX-018
$2.75 EA
GLX-020
$2.75 EA
GLX-021
$2.75 EA
GLX-022
$6.50 EA
GLX-023
$6.50 EA
GLX-024
$6.50 EA
GLX-025
$6.50 EA
GLX-026
$6.50 EA
GLX-027 BLK
$5.25 EA
GLX-028 BLUE
$5.25 EA
GLX-029
$2.00 EA
GLX-030
$2.00 EA
GLX-031 BRN
$5.25 EA
GLX-032
$2.00 EA
GLX-033 BEIGE
$5.25 EA
GLX-034
$2.00 EA
GLX-035 PUR
$5.25 EA
GLX-036 PINK
$5.25 EA
GLX-037
$2.00 EA
Item Number
Qty
Cost
Total
GLX-038
$2.00 EA
GLX-039
$5.00 EA
GLX-040
$5.00 EA
GLX-041
$5.00 EA
GLX-042
$5.00 EA
GLX-043
$5.00 EA
GLX-044
$5.00 EA
GLX-045
$5.00 EA
GLX-046
$5.00 EA
GLX-047
$5.00 EA
GLX-048
$5.00 EA
GLX-051
$5.00 EA
GLX-052
$5.00 EA
GLX-053
$5.00 EA
GLX-054 BLUE
$2.25 PR
GLX-054 D BRN
$2.25 PR
GLX-054 GRN
$2.25 PR
GLX-054 ORG
$2.25 PR
GLX-054 PEARL
$2.25 PR
GLX-054 WHT
$2.25 PR
GLX-054 N
$5.00 EA
GLX-055
$5.00 EA
GLX-056
$5.00 EA
GLX-057
$5.00 EA
GLX-058
$5.00 EA
GLX-060
$5.00 EA
GLX-061
$5.00 EA
GLX-064
$5.00 EA
GLX-065
$5.00 EA
GLX-066
$5.00 EA
GLX-067
$5.00 EA
GLX-068
$5.00 EA
GLX-069
$5.00 EA
GLX-070
$5.00 EA
GLX-071
$5.00 EA
GLX-072 BEIGE
$2.25 EA
GLX-072 BLUE
$2.25 EA
GLX-072 BRN
$2.25 EA
GLX-072 PINK
$2.25 EA
Sub total
GST (5%)
PST (8%)
Total
