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Translation:
Privacy and Security Policy
Conditions of Use
(Disclaimer)
***IMPORTANT: PRINT, FILL OUT, AND FAX, or MAIL THIS ORDER FORM***
Access Heritage Inc (formerly The Discriminating General)
27 Auriga Drive - Unit 38
Ottawa, ON
K4M 1E4
CANADA
Phone: 613-692-6947
FAX: 613-317-7574
Country Code (001)
DATE:_____________________
Name: __________________________________________________________________________
Address: ________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
_________________________________ Country:_____________________________________
Daytime Phone: ______________________
e-mail
Address:______________________________
(We need a phone number no matter what country you live in.
E-mail
address is
for sending your shipment tracking information.)
Item # |
Quantity |
Item Description |
Price for One | Total Price |
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Shipping |
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(for Canada residents only) GST |
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(for Ontario residents only) PST |
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Total |
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Please Ship my order:
United Parcel Service (UPS Courier)
Payment:
Cheque/"International" Money Order
Please
Charge my:
VISA
Mastercard
(Personal Cheques allow 30 days to clear bank)
Expiry:
-
Security Code(Back of
Card)
______________________________
ONLY U.S. CUSTOMERS USE U.S. DOLLAR PRICES.
CANADIAN AND OTHER NATIONS PROCESSED IN CANADIAN DOLLARS.
Additional Information: