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Order Form - Whitewater Softener Services Ltd.
Delivery within York Region? Yes       No

Product Qty Unit Price Ext Price
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GST:
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Bill To
Name:
Address:
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Ship To
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Phone:
Email address:

Cheque enclosed
VISA (please provide card info below)
Name on Card:
Card No:
Expiry: Month Year

Please print and fax or mail your completed order form to:
White Water Softeners
18180 Leslie St.,
Newmarket, Ont. L3Y 7V1

Fax: 905-953-9469

Thank you for your order.