Order by FAX, Phone or Mail ---- Canadian Order Form

Order by FAX, Phone or Mail ---- Canadian Order Form Canadian Order Form ---------- Order by FAX, Phone or Mail

Fax completed form to: 1 - 519 - 462 - 2002 (VISA)
Call us Toll Free at: 1 - 877 - 245 - 7444 (VISA)
OR
Mail completed form to: Carlisle Bay Co. Ltd.
59 Harwood St. South
Hickson, ON
N0J 1L0
Canada

Note: These filters have the optional Carbon prefilter installed, if you would like the regular HEPA filters without carbon, please use the F101 order form

I own a: Fantom Fury or Sears Destiny vacuum cleaner

HEPA Filter................................................................Please ship me ___ F101-C HEPA filters @ $31.95 ea. =________
Two Filter Bonus Pack..........................Please ship me ___ F101-2-C HEPA 2 Filter Bonus Packs @ $49.95 ea. =________
Six Filter Special Pack......................Please ship me ___ F101-6-C HEPA 6 Filter Special Packs @ $124.95 ea. =________

Shipping and Handling....Approximate delivery times: 14 days via parcel post, 7 days via express post Shipments to addresses outside of Canada please use the USA and International form.
Parcel Post = FREE
Optional Express Post =$6.95

Shipping and Handling = ____________

SubTotal = ____________

GST (5% of SubTotal) = ____________

Ontario Only PST (8% of SubTotal) = ____________

TOTAL (SubTotal + Taxes) = ______________
CDN Funds

Ship To: (Please Print)

Name: __________________________________________________________________

Street: __________________________________________ Apt: __________

Town/City: ______________________________________ Prov: __________

Postal Code: ____________ Phone: __________________________

Country.....Canada

Payment Information....(Please check one of the following)....Do not send cash by mail.

____ Check No. ____________ enclosed. Please make the check out to Carlisle Bay Co. Ltd.

____ Money order enclosed. Please make the money order out to Carlisle Bay Co. Ltd.

____ VISA....Name on the card: (Please Print) ______________________________________

Card Number: ______________________________________ Exp. Date: ______ / ______

Signature: _____________________________________ Date: ______________________