WALL-ALBUM® -- Wholesale Order

Wall-Album® - Wholesale

Volume Discounts from M.S.R.P.

For Retailers Only. Minimum Order is 1 box of 10 units. All shipments are F.O.B. Mississauga, Ontario, Canada. Payment in full (Cheque, Money Order, MC / VISA) must accompany your first order. To apply for terms, please complete Credit Application information with at least 3 Supplier References. US Shipments totalling more than US$200 may incur a flat brokerage fee (e.g. UPS charges $15 for orders totalling up to $1,000). To minimize shipping charges, please order enough to warrant the extra $15 broker fee.

ORDER DETAILS
Item	Description	Quantity	Unit Price	Extended Price
WA-4612	Fridge Edition		$12.50
WA-4620	Mixed Edition		$12.50
WA-4620c	Clear Edition		$22.50
WA-4625	Landscape Edition		$13.50
WA-2357	Collector Edition		$12.50
WA-2380	Business Edition		$15.00
I pay GST and PST (ONT) I pay GST (CA) I don't pay Sales Tax (US & INT)
Volume Discount 100+ = 5%			Subtotal
			Volume Discount
* International Order
			GST (Canada)
Ship via			PST (Ontario)

F.O.B. Mississauga, Canada. Freight charges will be added to invoice. International Orders are charged according to the Service rate.
SHIPPING DETAILS
* First Name
* Last Name
* Title
* Company
* Shipping Address(1)
Shipping Address(2)
* City
* State or Province
* Country
* Zip or Postal Code
Telephone No.
Fax No.
* E-mail
PAYMENT DETAILS
I am mailing my Cheque or MO:			Yes No, I have a Biospace Account
I want to pay by credit card:			Visa Mastercard
I'll phone in my card number:			Yes No, details provided below
** Credit Card Number:
Expiry Date:			mm yy

PLEASE PRINT & SAVE RECEIPT FOR YOUR RECORDS.
If "Server Error" appears, please click "Back" and "Place Order" again.
**If you have Security concerns, you can call (or print & fax Form) toll free to:
1-800-592-5286 (Canada & USA) or 905-278-7164 (Local & International).

To order by Mail, please print completed Form and mail with Cheque or MO to:

BIOSPACE CORPORATION
1720 Lincolnshire Blvd.,
Mississauga, Canada L5E 2S7
Tel/Fax (905) 278-7164

E-mail: sales@biospace-corporation.com

Orders are shipped on the day your Cheque, Money Order or Credit Card transaction is cleared by our bank (allow 5 business days). We ship via UPS or Parcel Post to most addresses in North America (allow 5 business days). For multiple and international orders, confirm shipping charges first (submit form above) or tel / fax 905-278-7164.

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Wall-Album®, SUPERSTRIPS™, PlayMaker®, Bathbar® & Washbar® are trademarks of Biospace Corporation.
Biospace® is a registered trademark of Biospace International AG. © Biospace Corporation.
All rights reserved. U.S. and International Patents apply or are pending.

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