Order Form
You can print this order form and return it to one of the
locations below.
Name: ____________________________________________________
Company: ____________________________________________________
Address: ____________________________________________________
____________________________________________________
Phone: _____________________ Fax: ________________________
Email: ____________________________________________________
Please send me the following products:
--------------------------------------------------------------
| Qty|Product Description |Unit Price | Amount |
|----+----------------------------------+------------+---------|
| | | | |
|----+----------------------------------+------------+---------|
| | | | |
|----+----------------------------------+------------+---------|
| | | | |
|----+----------------------------------+------------+---------|
| | | | |
----------------------------------------------------+---------|
Sub-total| |
|---------|
Shipping & Handling (see below) | |
|---------|
GST (5%) | |
|---------|
Total | |
---------
Please indicate your method of payment:
____ Visa ____ MasterCard
Card Number _____________________________ Expiry Date _________
Signature _______________________________
____ Cheque or money order (attach and make payable to the Minister of Finance)
____ Alberta Queen's Printer account number:__________________
____ P.O. (please attach) with IMAGIS account number:_________
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* There is no shipping and handling charge for orders delivered to locations in *
* Alberta. Outside Alberta, the following shipping and handling charges apply: *
* - $6.00 plus GST on orders of $19.99 or less *
* - $10.00 plus GST on orders of $20.00 or more *
* Alberta Gazette subscription orders, shipping and handling charges of $40.00 *
*********************************************************************************
GST Registration Number 1240702513RT
Return this order form in person, by fax or mail to:
Alberta Queen's Printer
Main Floor, Park Plaza
10611 - 98 Avenue
Edmonton, Alberta
T5K 2P7
Telephone: (780)427-4952
Fax: (780) 452-0668
E-Mail: qp@gov.ab.ca
For toll-free access from anywhere in Alberta, call 310-0000.
Thank you for your order.