Mail in Order Form

Name
Company
Address
City
Province / State
Postal Code
Country
Telephone Number
Email Address

Would you like email product updates ? YES NO

Quantity

Description

Unit Cost

Extended

    Shipping
    SubTotal
    HST 12% For Canada Sales
      TOTAL

Payment Type: Certified Cheque / Money Order Credit Card

*** Please call (604) 878-8588 for a quantity discount ***

If paying by certified cheque or money order, please make payable in $USD funds. Mail to: >

DYNAWAVE Technologies Ltd.

4386 Strathcona Road

North Vancouver, BC V7G 1G3

Canada

Paying by credit card >

visa mastercard amex

card number

expiry (mmyy)

3 digit security number

name on credit card

 

Additional Comments

 

Thank you for your business!

Return to our HOME PAGE