Product Order Form

To place your order, simply fill in the fields in the form below. Minimize this window to continue shopping. Open this window again to post additional items. Once you have finished placing your order, complete the lower portion of the form and click Submit.

* Indicates required fields
Name:*		Country:*
Shipping Address:*		Telephone: (include area code and country code where required)
City:*		E-mail:*
Province/State:*		Confirm e-mail:*
Postal Code/Zip Code:*		Member Number: (if applicable)

Shipping options are available. Flat rates for deliveries by regular post are listed in the table below. For rush delivery we offer Expresspost and Purolator (courier service). Choose your method of shipment from the drop-down menu. All shipping costs are confirmed with the customer prior to delivery.

Value Shipping (Regular Post)
Location:	Cost:	Delivery:
Canadian orders	$8.00	allow 5 - 15 days
U.S. orders	$10.00	allow 2 - 4 weeks
International orders	$12.00	allow 3 - 5 weeks

Comments? Questions? Special Request?

Credit Card Information:

Name that appears on the card:

Expiry Date: Month Year

Card Number:

Please note: this is not a secure online order form. If this is a concern, please
fax your credit card information to L'annel Canada, 1-780-487-1681.

Were you referred to this site? Yes No

If you chose "Yes", please provide us with the name:

Quantity	Code	Description	Unit Price	Total















		Subtotal
		Shipping & Handling
		GST #871397998
		Total Due