Merchandise Order Form

To pay by check or money order, please print this form and send it with your payment.
Please PRINT CLEARLY in block letters.

Name            ______________________________________________________

Address         ______________________________________________________

                ______________________________________________________

City            ______________________________________________________

State/Province  ______________________________________________________

Postal Code     ______________________________________________________

Country         ______________________________________________________

Phone (day)     ________________________ (eve)________________________

E-mail address  ______________________________________________________

Black T-Shirt   	  	XXL______   Qty______ x $20    Amount  $________
				 XL______   Qty______ x $20    Amount  $________
				  L______   Qty______ x $20    Amount  $________
			Youth Small______   Qty______ x $20    Amount  $________
Black Tank Top 	    M(chest size 34)______   Qty______ x $20   Amount  $________
		    L(chest size 36)______   Qty______ x $20   Amount  $________
	                                            	      SUBTOTAL $________
Add Provincial Sales Tax (8%, Ontario residents only)
    ($1.60 tax for $20, etc...)					   PST $________
Add Goods and Services Tax (7%, Canadian residents only)
    ($1.40 tax for $20, etc...)					   GST $________
Add Shipping ($6.95, add $2.00 per each additional item)
    International orders please add:
         USA & Mexico   $7.00
         All other countries $12.00            		      SHIPPING $________
								 TOTAL $________

Questions/Comments?  Email us at piledriver@sympatico.ca

Please make checks / money orders payable to "Denise Chapital" and mail to:
Denise Chapital, c/o DogBite Records
806-785 Browns Line
Toronto, ON, M8W 3V8

We will ship your order within 1 week of receiving your payment. Please allow 1 to 5 weeks for delivery.

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