"Phyllis' Miracle"

Transformed By Cancer
Order Form

Please PRINT clearly using BLACK ink and be sure to enter your FULL address and PHONE number
(it may be important to contact you regarding your order):

Ordered by: qMr. qMrs. qMiss/Ms.

First Name:___________________ Family Name:____________________________
Street Address:________________________________Apt:_________
City:_________________________ Prov/State:_______ Postal/Zip Code_________
Day phone number:(____)_______________ e-mail address:_______________________

Send to (IF different from "Ordered By"): qMr. qMrs. qMiss/Ms.
First Name:___________ Family Name:________________
Street Address:________________________________Apt:_________
City:_________________________ Prov/State:_______ Postal/Zip Code_________

qPlease send C.O.D. ($69.99 per video + $4.90 G.S.T. + $10.00 shipping/handling = $84.89 CN)

qEnclosed is a cheque, money order or bank draft in Canadian funds payable to:

Lorna Thomas Productions Inc., #28 Sundance, Edmonton, Alta. T5H-4B4
Item      Video- Phyllis’ Miracle                   Qty._____ Price $69.99  Total__________
(a) Total______________________________________________
(b) Shipping & Handling-(based on "a"—see below)______________________
(c) Subtotal ("a"+"b")_________________________________
(d) NS,NB & NFLD addresses-HST 15%(of "c")_______________
(e) Other CAN Addresses-GST 7%(of "c")____________________
(f) B.C. Addresses-PST 7%(of box "c")_____________________
TOTAL Enclosed in $CAN ("c" + appropriate taxes)____________

 

Shipping and Handling Charges in Canadian Dollars
(For each separate destination)

Total Order (a)

Can

U.S.

Other Countries

$30.01 - $100.00

$6.40

$7.35

$10.50

$100.01 - $200.00

$8.25

$10.45

$12.50

$200.01 & up

$10.40

$12.55

$14.50

 

 

 

 

www.lornathomasproductions.com

Tel/Fax: (780) 420-6666. Email: lortho@telusplanet.net