Order Form - Lemuel Violins

Lemuel Violins
Fine String Instruments, Bows, Accessories and Supplies
324154 Mt. Elgin Rd., Mt. Elgin, Ontario, Canada N0J 1N0 | Phone: (519) 425-7858 - Fax: (519) 425-9989
Email: violins@violins.ca - On-line catalog: www.violins.ca

Fax or mail this form to us, or use our Secure Online Form.

Ship to:

Street address:

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Telephone: (req.)

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DATE:

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Shipping Rates: Charts at http://www.violins.ca/ordering.html or contact us.

Quantity

Model #

Description

Each

Amount

SHIPPING & INSURANCE

Sub-Total

CANADIANS: (HST Rates: Ontario, NB, NF - 13%, Nova Scotia - 15%, BC - 12%, Other - 5%) ) (87082 5270)

HST

Total

Comments: Currency data courtesy coinmill.com

Ship to:
Street address:
City, State/Prov.
Country
Zip, Postal Code:
Telephone: (req.)
Fax:
Order Placed By:
DATE:
Email address:
Signature:
Payment Method:	Please Circle: VISA \| MC \| Money Order/Check
CC Number:
Expiry Date:
Name on Card:

Quantity	Model #	Description	Each	Amount











		SHIPPING & INSURANCE
			Sub-Total
		CANADIANS: (HST Rates: Ontario, NB, NF - 13%, Nova Scotia - 15%, BC - 12%, Other - 5%) ) (87082 5270)	HST
			Total