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Print This Form, Fill It Out And Mail Or Fax With Payment To...

The Letterhead Website
144 Hill St., E.,

Fergus, Ontario,
Canada N1M 1G9

Fax to 519-787-7446

 

Name:_______________________________________________________________________________

Business Name:_______________________________________________________________________

Address:______________________________________________________________________________

City:_______________________________________________    Prov./State:________________________

Postal Code:_____________________________     E-Mail:_______________________________________

Country:___________________________________     Phone:______________________________________

 

Check Off Your Choices

  • I'm a Letterhead Website Supporter! Here's my $50 US!
  • Send me a Letterhead Website T-shirt.

How many @ $20 each? __________

Size?.....S_______   M_______   L________    XL_______   XXL ________   XXXL ________

 

  • Enclosed is my cheque for $_______________
  • Use my Visa
  • Use my MasterCard
  • Use my American Express

Card Number:__________________________________________

Expiry Date:___________________________________________

Name On Card:_________________________________________

Signature: _____________________________________________

 

 

Questions!

Call Steve or Barb
519-787-2673

Fax us at
519-787-7446

Please Make
Cheques payable to
The Letterhead
Website

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