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:

BILLING 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

Telephone(required)

BILLING

Specify method of payment

 

Cardholder Name

Card Number

Expiration Date (month/year )

CSC code (3 digit code on back of card)

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 24, 2013                                                                                                                                                 Copyright 2003-2013 Maternal Source