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Fax ,mail or on-line order form: Speargrass Specialties, Box 298, Eatonia, SK., CANADA S0L 0Y0

Date:  _________

Ship To: 

             Name:  _______________________________

             Address:  _____________________________

            City:  _________________

            Province: _________________ , Country _____________ , Postal Code  _________

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Billing Information:  Cheque or money order in the amount of       $ ___________

ON LINE   _________________________________________________________________________________

Title  Code                 Price                 Quantity                 Ext                 Shipping

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                                                                                       Total Price:  $ ________

                                                                                 Less Discount:  $ ________

                                                                                           Shipping:  $ ________

                                                                                                 Total:  $ ________

                                                             GST and PST are not applicable