After printing this form please fill in the amounts for the items you wish to order, total them and write the total in the Total Balance Due space. Then fill in your Name and Address in the spaces provided and if applicable your visa details. All amounts are in Canadian Dollars.
Amount |
||
| Cost Per Copy | $40 | __________ |
| Cdn. residence (except N.S., N.B., NFLD) add 7% G.S.T. | $2.80 | __________ |
| N.S., N.B. & NFLD. residence add 15% HST | $6.00 | __________ |
| Total per Copy | Total | __________ |
| Times Number of Copies | X Copies | __________ |
| Total | __________ |
Total Balance Due = __________
Name _____________________________________________
Street ________________________________________________________________
City _________________________ Province/State _____________________
P.C./zip ______________________ Phone number ________________________
Email address _____________________________________________________
Visa Information (if applicable)
Visa card holder name ________________________________________
Visa card Number _________________________________ Expiry date __________
Signature ____________________________________
Mail or fax to: Insight Financial Corporation, Box 1118, Okotoks, Alberta, Canada, T1S 1B2.
Phone number: (403) 995-9598
Email address: hh1@heinzegroupcom Web site: http://www.heinzegroup.com
Email users be be advised that to reduce spam, we have removed the period before the com in our email address. Please insert a period between heinzegroup and com to read heinzegroup.com to make the address legitimate. Also, we use spam filters, which sometimes filter legitimate email, so please confirm that we received your email.