Mineral Specimen Order Form

Please fill out the following form, including information about the specimens you are interested in. Note that you are required to enter information in fields marked with a *. The "Ship To" information is not required if your shipping address is the same as your billing address. P.S.T. is only applicable to residents of Ontario; G.S.T. is only applicable to residents of Canada. For payment in US$, deduct 22% or multiply by 0.78. When you have completed the form, please click the "Submit Completed Form" button below, and the form will be e-mailed to David K. Joyce. If you wish to clear all the information in the form. click the "Clear" button below. If you have any questions or comments, please e-mail me at dkjoyce@bellnet.ca

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Supplier
Prod. ID
Description
Qty.
Price Subtotal
Telephone Number
E-mail address
*

Ship To (required)
*Your Name
*Your Address
*City
*State/Prov
*Country
*Zip/Postal Code
Bill To (if different than shipping address; otherwise leave blank)
Your Name
Your Address
City
State/Prov
Country
Zip/Postal Code
Preferred Method of Payment:
Note: If you would like to pay with VISA or Mastercard, please select Visa or Mastercard in the "Preferred method of payment field" and I'll contact you to arrange a secure transfer of your credit card information by phone or fax.
NS residents add 15% HST
NB, NL and ON residents add 13% HST
BC residents add 12% HST
AB, SK, MB, QC, PEI, YT and NT residents add 5% GST
Subtotal ($Can.)
H.S.T. / G.S.T.
Shipping
Total ($Can.)
Total ($US)
If you'd like to continue browsing, you can minimize this window, and maximize it again when you see something you'd like to add. If you're ready to send this information, click the "Submit Completed Form" button.