“CIRCULATOR” FOOT MASSAGE MAT

ORDER FORM

for orders from Ontario, Canada

            Please note: If you are a wholesale customer, please contact us for wholesale pricing and opportunities.

 

Prices are in Canadian dollars

Please send me _______Circulator® foot massage mat(s) at $39.95 each

 

 

 

 

 

Shipping & Handling: first mat $6.95

+ $1.95 each additional 

 

 

 

Subtotal

 

 

 

Ontario residents add 13% HST

 

 

 

Total

 

 

I enclose full payment in the form of     bank draught     money order  

Please make cheques and money orders payable to K. Baggio.

 

Name  ___________________________________________

Address  _________________________________________

   _______________________________________________

City  _____________________________________________

Province  _________________    Postal Code  _____________

Telephone  (        )_____-________   Fax  (        )_____-________

 

Signature   ________________________________________________

 

 

                    Mailing address:  The Circulator

c/o Baggio

6078 Old Church Rd.

Caledon East, ON

L7C 1G6