THE HEALTHY HOME CENTRE - ORDER FORM

Please print out this form and mail or fax it to the Healthy Home Centre, c/o Safe Start, 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, toll-free (in B.C. only) 1-888-331-8100. If no one is available to answer your call, please leave a message and we will call you back.

PRODUCT #   PRODUCT NAME   QUANTITY   PRICE   TOTAL
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Please charge my Credit Card VISA MasterCard

Name on Credit Card: ________________________________________________

Card Number: _______ _______ _______ _______  Expiry Date: ______ /______

Signature: __________________________________________________________

Subtotal:		   ___________

+ 7% GST:		   ___________

+ 7.5% PST:		   ___________
+Delivery:
(see below)		   ___________

TOTAL:		   ___________


Name: ________________________________________________________________________________________________


Address: ______________________________________________________________________________________________


City: ________________________________________ Province: __________________ Post Code: __________________


Tel Number: _____________________________________ Fax Number: _______________________________________

Tell us what you think!
How did you hear about the Healthy Home Centre?_____________________________________________________

Did you find the safety and health information in this website helpful? ____________________________________


Our shipping charges (before tax) are as follows:
Orders from $1 to $34.99 = $4.00  /  $35.00 to $74.99 = $6.00  /  $75.00 and up = $8.00  /  Over $250 = Shipping is free
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 charges apply to bulk orders.

Gates: Because of their irregular size and weight, gates are shipped separately by courier. Add $10.00 to your shipping charges for one gae, and $5.00 for each additional gate ordered.

Ordering tip: Get together with a group and combine your orders. Then you can split the shipping costs, or order $250 worth of products and receive free shipping!


FOR OFFICE USE ONLY:     Date received: ________________________  Date sent: ________________________