785000 Alberta Limited.
William Bilozir / Donna Jones
Box 22, Site 11, RR#1
De Winton, AB, T0L 0X0 Canada
Ph / Fax: 403 938 6066
bismuth@bilozir.net

SHOT & RELOADING SUPPLIES: ORDER FORM

Customer Information:
Customer Name:
Address:
City:
Province/State:
Postal Code/Zip:
Telephone:
Fax:
E-Mail:
Shipping Information: ( If different from above )
Ship To:
Address:
City:
Province/State:
Postal Code/Zip:
Telephone:

Ordering Information:
Enter Quantity desired then Click on "Calculate Results"
Item Description
Item #
Qty. to
Order
US Price
Each
$
$
$
$
$

$
$
$
$
$
$

$
$
$
$
$
$

$
$

$
US Exchange will be calculated at annual rate.
Shipping and Handling will be added.
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An invoice with all totals will be mailed/emailed to you
before your order is processed.
Please Note: The information you provide on this form, including credit card information  will be sent through your email. If you prefer please contact us by phone to provide credit card information
Payment Options:
Pay by VISA Master Card
   
Allow 2 weeks for delivery.
Shipments will not be made until credit card information has been confirmed. If you prefer, please contact us with your credit card information.
 
Send COD
Payment made on receipt
   
Click Below to Submit Your Order

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