FIELDS MARKED WITH * ARE REQUIRED!

Your E-Mail Address:*  

          Your Name:*  

            Address:*  

               City:*  

     Province/State:*  

    Postal/Zip Code:*  

            Country:*  
 
          Telephone:*  
         (with Area Code)

  Please send me an invoice for  
    *(How many at $9.95 ea?)   Stallion pucks (approx. 60 grams)
   *(How many at $10.95 ea?)   Stallion soft edge pucks
   *(How many at $11.95 ea?)   Gladiator pucks (approx. 75 grams)
   *(How many at $12.95 ea?)   Gladiator soft edge pucks
   *(How many at $19.95 ea?)   Black hats
   *(How many at $19.95 ea?)   White hats

        * plus PST and shipping. 

  I prefer to pay by Cheque   Money Order  PayPal  C.O.D. (Canada only)

  Comments:                       
  

  When done, please  or 
  


  Or you may choose to telephone your order, or print this page and  
  fax or mail the completed form to:      PRECISION PUCKS
                                          13940 Chief Lake Road
  Fax: 1-250-967-4412                     PRINCE GEORGE, BC  V2K 5K1
  Telephone: 1-250-613-PUCK (7825)        Canada

  We will send you an invoice for the total cost of pucks, taxes & shipping.
  Your indoor hockey pucks will be shipped within 14 days of receiving your 
  payment.