THE SAFETY STATION - ORDER FORM Print this form and mail or fax it to the Safety Station, 4480 Oak Street, Vancouver, B.C. V6H 3V4. Fax 604.875.2440. Or phone in your order during operating hours by calling 604.875.2244 or toll-free 1-888-331-8100. * Please note: prices are subject to change * PRODUCT #   PRODUCT NAME   QUANTITY   PRICE   TOTAL ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________ ___________ ______________________________________________   ________ x ___________ = ___________           Subtotal: ___________ Please charge my Credit Card VISA MasterCard Name on Credit Card: ________________________________________________ Card Number: _______ _______ _______ _______  Expiry Date: ______ /______ Signature: __________________________________________________________ 5% GST: ___________ 7% PST: ___________ Shipping: ___________ 5% GST on Shipping: ___________ TOTAL: ___________ Name: ____________________________________Address:_________________________________________________________ City:______________________________________Province:____________________________Postal code:__________________ Tel Number: ______________________________Cell Number: _________________________Fax:_________________________ Tell us what you think! How did you hear about the Safety Station?______________________________________________________________________ Do you have any suggestions/comments about our website? _______________________________________________________ Our shipping charges in Canada (before taxes) are as follows: Orders from $1 - $34.99 = $4.00;  $35.00 - $74.99 = $6.00; $75.00 - $199.00 = $8.00, gates are priced separately. Free shipping on orders over $200 (not including gates). Products are shipped by Canada Post unless otherwise specified. Please allow up to two weeks for delivery. Delivery time may be longer for items that are back-ordered or out of stock. Special freight may apply to bulk orders. Sorry but we cannot ship to the US or Europe. Shipping charges for gates: To prevent damage during shipping, the Safety Station ships gates by Purolator. Please call us for shipping rates at 604-875-2244 . FOR OFFICE USE ONLY:     Date received: ________________________  Date sent: ________________________