2019 Easy Order Form Bill To: Contact ___________________________________________________________________ School/Institution _____________________________________________________ Address ___________________________________________________________________ City ________________________________________________________________________ Prov. ______________ Postal Code _________________________________ Phone _____________________________________________________________________ Email ______________________________________________________________________ Ship To: (If different from “Bill To”) Contact ___________________________________________________________________ School/Institution _____________________________________________________ Address ___________________________________________________________________ City ________________________________________________________________________ Prov. ______________ Postal Code _________________________________ Phone _____________________________________________________________________ Email ______________________________________________________________________ Principal/Director’s Name _____________________________________________________________________________________________________________________________ 3075 Line 8, RR 2 Bradford, ON L3Z 3R5 Phone Free: 1-800-268-1268 Fax Free: 1-800-567-8054 www.WINTERGREEN.ca PAYMENT METHOD All orders from individuals must be accompanied by payment or credit card information. Cheque Enclosed VISA® MasterCard® American Express® Charge our account: Authorized Purchase Order # Account # (if known) Card # / / / Expiration Date / Signature } *Quebec Residents: QST is calculated on the Subtotal + the GST Promo Code (if applicable) Qty. Item Colour Name of Item - Description Price Each Total Price Number Subtotal (Incl. Merchandise Total & Shipping & Handling) Add 15% Shipping & Handling HST or GST PST or QST where applicable Subtotal (Incl. Subtotal & Taxes) Total Gift Card Redemption: $ _________ Card #: ______________________________ (Subtract Card Amount from Subtotal) Total this side: $ ___________ + Total other side: $ ___________ Merchandise Total If you need more space, please use the back of this form. Phys-Ed WINTERGREEN Phys-Ed