Order Form
| First Name, Initial, Last Name : | |
| Street Address : | |
| Apt : | |
| City : | |
| Province/State : | |
| Postal Code/Zip : | |
| Phone Number with Area Code : | |
| Best time to call you : | Today's Date : |
| e-mail address : | |
| Method of Payment (Pick One) |VISA | Mastercard | PERSONAL CHEQUE | MONEY ORDER | BANK DRAFT |
| If paying by VISA/MasterCard, the name on the card must be the name given above. |
| If VISA/MasterCard, Enter Card Number |
| If VISA/MasterCard, Enter Expire Date |
| Signature : |
| Item # | Product Description | Quantity | Unit Price | Total Price |
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Please print out the form, fill it out and fax, or send it by mail to the address below:
Birds and Bugs
1184 Speers Road
Unit 3, Main Floor
Oakville, Ontario, Canada
This form may also be attached to your e-mail as an order.
Note: If you would like us to contact you by e-mail, please include your e-mail address with the order form. E-mail addresses will not be shared with any other person or organization.