STANDARD Soubra™ ORDER FORM FOR
NON CREDIT CARD ORDERS

Simply fill out this form, then print it off and mail it to us, along with your cheque or money order, to:

O.M.T. Ltd.,
61 Herring Cove Rd.,
Halifax, Nova Scotia,
B3N 1P9
Canada
SPECIAL NOTES

If you send your order by registered mail we will reimburse the cost of registration to the nearest dollar with your order.

We accept payment in equivalent Canadian dollars. Please check our PRICE/TERMS page for the current conversion rate.

                        Type or write in the quantity for your selection(s).

For single selections at $25.00 USD each.     For selections in pairs at $45.00 USD/pair.

1/2" WIDTH
                    REINFORCED                                          REINFORCED

3/4" WIDTH
LIGHT   REINFORCED                       LIGHT   REINFORCED

1" WIDTH
LIGHT   REINFORCED                       LIGHT   REINFORCED

1 1/4" WIDTH
LIGHT   REINFORCED                       LIGHT   REINFORCED

IMPORTANT: To avoid delay, please remember to add the appropriate shipping and handling fee (orders under $80.00US: $3.50, orders over $80.00US: $7.00).

Total payment included: $

Name:

Mailing Address:

Phone:

E-mail:

Do you wish to be notified by E-mail when your order is shipped?

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