Print this form and mail it to : 

 
Debby's Country And Western Boutique
146 Grant Ave.
Amherstburg Ont.
CANADA
N9V 2R2

Your Mailing Address ...                 Ship To: (if different from mailing)

Name       : ________________________  Name       : ________________________       

Address    : ________________________  Address    : ________________________       
                                                                                  
           : ________________________             : ________________________

Postal/Zip : ________________________  Postal/Zip : ________________________

EMail      : ________________________



Qty   Product# and                   	         		 Unit     Total     
      Description                    	Color       	Size	 Price    Price

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       							Sub Total       __________


              						Shipping	__________
		Shipping : (see Shipping on the     (Subject to GST)       	  
       			'Info' page for prices)     	
							GST (7%)        __________

  [  ] Surface Mail					PST 
							(Ont 8%)        __________
  [  ] Xpress Post (Canada Only)                						
							
  [  ] UPS                                              Grand Total     __________

  
Note : 	Make Cheque or Money Order payable to...

		Debby's Country And Western Boutique