PRINT OUT DVD ORDER FORM CANADA: PAY BY CHEQUE OR CREDIT CARD. Complete all details including number each DVD required then submit by fax or post to nearest office below:

 
Credit cards accdepted
Creation Research PO Box 31034, 475 Westney Rd. North Ajax, ON L1T 3V2
Ph. (905) 686 7782 Fax. (416) 946 1678
CLIENT DETAILS:
Date: Month: Year:
Title: First Name:
Surname:
Company: Position:
Address No.:
Street:
State:
Zip:
H. Phone: W. Phone:
Fax: Email:
Prices Canada 1 - $25.00 2 - $45.00 3 - $69.00 4 + $18.00 ea.  
ORDER DETAILS: All DVD's Post Free 
DVD'S Qty. Click arrow to select DVD Titles. DOCUMENTARY or TV SHOWS.
 DVD'S Qty. Click arrow to select DVD Titles. DOCUMENTARY or TV SHOWS.
Item 1 Item 6
Item 2 Item 7
Item 3 Item 8
Item 4 Item 9
Item 5 Item 10
DVD'S Qty. LECTURES.
 DVD'S Qty. LECTURES.
Item 11 Item 18
Item 12 Item 19
Item 13 Item 20
Item 14 Item 21
Item 15 Item 22
Item 16 Item 23
Item 17 Item 24

Please send the above order to: ALL PRICES INCLUDE GST

Name:............................................................................. (PLEASE PRINT )

Address:.............................................................................Postcode.................................
Country:................................ Home Phone:........................... Work Phone:..............................
I ENCLOSE PAYMENT OF:.............................. by check (payable to:...CREATION RESEARCH...)
OR charge my credit card: Visa Mastercard (Please Select)
Credit card no.: Expiry date:....................
For security purposes, please turn your credit card over and copy the last three digits:______________
Signature of card holder:........................................................................