Order Form - Lemuel Violins

Lemuel Violins
Fine String Instruments, Bows, Accessories and Supplies
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:

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:

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

Quantity

Model #

Description

Each

Amount

SHIPPING & INSURANCE

Sub-Total

ONTARIO RESIDENTS 8 % PROVINCIAL SALES TAX

PST 8%

CANADIANS: 6% GST (14% HST: Nfld. NB and NS) (87082 5270)

GST/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
		ONTARIO RESIDENTS 8 % PROVINCIAL SALES TAX	PST 8%
		CANADIANS: 6% GST (14% HST: Nfld. NB and NS) (87082 5270)	GST/HST
			Total