b'Date 2019 ORDER FORMTO ORDERPhone Toll Free 1-800-268-1268WINTERGREEN Learning Materials, Fax Toll Free 1-800-567-80543075 Line 8, RR2Bradford, ONL3Z 3R5 Online www.WINTERGREEN.caBILL TO: (Please print) SHIP TO: (Please print)School/ School/Institution (if applicable) Institution (if applicable)Contact Name Contact NameAddress/P.O. Box Street AddressCityCityProv. Postal CodeProv.Postal Code Telephone ()Telephone () Email EmailUnitExtendedQty.Item #ColourName of Item - DescriptionEach PriceIf you need more space, please use the back of this form. Total this side: $ ___________ +Total other side: $ ___________Merchandise TotalPAYMENT METHOD All orders from individuals must be accompanied byAdd 15% Shipping & Handlingpayment, or credit card information.Cheque Enclosed Subtotal (Incl. Merchandise Total & Shipping & Handling)VISA} Card #/// HST or GSTMasterCard Expiration Date/American Express SignaturePST or QST where applicableCharge Our Account Authorized Purchase Order #Account # (if known)SubtotalGift Card Redemption: $ _________Card #: ________________________________ (Subtract Card Amount from Subtotal)Qty.Item #SubtotalOrdering a Gift Card?Gift CardPlace your order here!Promo Code(if applicable)TOTAL*Quebec Residents: QST is calculated on the Subtotal + the GST'