BRYN MAWR  BEARS MAIL ORDER FORM

Please print out this form and mail or Fax it to :- 

Bryn Mawr Bears,  8542 Emard Terrace, Sidney, B.C. V8L 1K3, Canada

Tel or Fax :-   (250) 656 6522                    E-mail :-   brynmawrbears@shaw.ca

Name(Mr.Ms.Mrs.)__________________________________Date___________________

Address _________________________________________________________________

________________________________________________________________________

Phone _______________  Fax ______________ E-mail ___________________________

Please send me the following Bears

Name ____________________________ Price __________________

Name ____________________________ Price __________________

Name ____________________________ Price __________________

Insured Shipping (Canada)      $15.00 per Bear ___________________

Insured Shipping (USA)           $ 20.00 per Bear ___________________

    Sub - Total ___________________

        Provincial Tax  (BC Residents only)  7.5% ____________________

                                                                          Total ___________________

Payment by  (Visa) (Amex) (Money Order) (Cheque) in $ Canadian (Circle one)

Card Name ____________________________________________ (Please print)

Card Number ___________________________________  Expiry Date _________

Signature _______________________________________

Thank you for your Order.  I will advise you when the Bear(s) are shipped.                Patricia