Wind Rose Linens: Victorian Shopping for Romance
294 Main St. Mahone Bay, NS, B0J 2E0, Canada
Phone: (902) 624-1211  Fax: (902) 624-1263

ORDER FORM
( Use your print button to print off a copy of this form and mail or fax it to Wind Rose Linens)
(Please Print Clearly)

Name:____________________________________________________

Address: __________________________________________________

City: _______________________              Province: ________________     Postal Code: ____________

Telephone Number: _________________            Fax Number:  _________________

Email Address: _________________________________________

 
Description of Item
Quantity
Item #
Item Price $
Monogram, Initial
Total $
1)
2)
3)
4)
5)
6)

 
A) Monogramming Charges, Please add $3 per initial/per item $                         A
B) Subtotal $                         B
C) Tax
( Atlantic Prov. 15%, Outside Atl. Prov. 7%, Outside Canada - excempt )		 $                         C
D) Shipping/Handling Charges $7.50 up to $100, $5.00 extra per $100 order $                         D
E) Total ( lines A through D ) $                         E

Method of Payment

Money Order
Cheque
Master Card
Visa
American Express
Account # _____________________
Expiry Date/Month/Year _____________________

Please add Signature:  _______________________________

Thank you for your order