Order Form

INSTRUCTIONS: Check ofT the products you nih 10 order and remit this ad together inth the total amount (in US Funds)

GENTliMtN: Rush toe my order1 O Enclosed is my □ check □ money-order O Please bill my O VISA □ MasterCard nflmE:_

STREET:_

CARD TYPE: CARD HD:_

EXPIRY:

SIGnflTURE:

Order Du Moil or Phone ~

213-1080 Bröughton Street ancouver, British Columbia Canada • VBG 2R8

Order Du Moil or Phone ~

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