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Order Form

BILLING ADDRESS
Company Name
Street Address
City, Province/State
Postal/Zip Code
Phone Number
Contact Person
Email Address
P.O. Number
Comments / Shipping Instructions:
 
SHIPPING ADDRESS
Same as Billing Address
(do not fill out below)
Company Name
Street Address
City, Province/State
Postal/Zip Code
Phone Number
Contact Person
Article Number No. of Pcs. No. of Packs No. of Cases

or Manufacturer's Cat. No. and Manufacturer's name
(if applicable)

(Minimum $50 Order)

(Tubing and Rod not
available in Packs)

  

You may also print and fax this order form to: 604-270-7461

 

Canadian Scientific Glassblowing - sales@cansciglass.com
120-2520 Simpson Rd., Richmond, BC (604) 270-7466
www.cansciglass.com