Orion Fax/Mail Order Form

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To order from our products, please print this form. Complete the required information and mail or fax it to us along with your payment information to:  Orion Electronics Supplies Inc., 40 Lancaster St.West, Kitchener, Ontario Canada N2H 4S9. All orders must be prepaid. Signed credit card orders are accepted by fax as well: Fax: 1(519) 576 9028 Thank you for your interest in our products. Phone: 1(519) 576 9902

Mail to: Orion Electronics Supplies Inc. 40 Lancatser St. W. Kitchener, Ontario, Canada. N2H 4S9

NAME:
Phone: Fax: E-mail:
SHIP TO: 
Company:
Address:

City, Province, Postal Code:

 Country:
Item number Item Description  Quantity  Unit Price Extended Price
         
         
         
         
         
         
         
Subtotal
  
Billing Information

PST 7% (Ontario)

  
All prices in Canadian Funds! To convert to other currency click HERE
GST 8%
  
Charge My: Mastercard VISA  Check or Money Order
Shipping
   
Credit Card Number:
Expiration: Total  
Name as on Card:

Signature:

Orion will confirm Sipping & Insurance with you before processing your order.

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Copyright © Orion Electronics Supplies Inc. -2006