To order West Crystal products, simply fill out this form and click the Submit Button at the bottom of this page. You can also print out this form and fax it to (250) 765-3308, or mail it to:

West Crystal Company Ltd. 10 - 2550 Acland Road Kelowna, BC  V1X 7L4

COMMUNICATIONS CRYSTAL ORDER

	E-mail (*Required)						Date
	Customer				Ship to
	Order placed by:				Phone:
	P.O. No.				Fax:
	US residents tick N for PST, GST, HST. Regular delivery is 2 1/2 weeks and Rush is 6 business days for a surcharge of 50% over regular prices.

PST

Y

N

HST

Y

N

RUSH

Y

N

GST

Y

N

SHIP VIA

VISA / MASTER CARD NO.

EXPIRY

	QTY	Tx/Rx	MAKE/MODEL	CHANNEL FREQUENCY	CRYSTAL FREQ (IF KNOWN)
1
2
3
4
5
6
7
8
9
10

	OBSERVATIONS:
** Please check box to confirm your order is ready to submit: (*required)

Copyright © 2008 West Crystal Company Ltd. All rights reserved.