Long Pond Hockey Enterprises
c/o Howard Dill
RR #1, Windsor, Nova Scotia Canada   B0N 2T0


PLEASE PRINT AND MAIL IN THIS FORM

Name:______________________________________________________________

Address:____________________________________________________________

Province/State:________________________ City: __________________________

Ph.#:__________________________ Postal/Zip Code: ______________________


Description
Qty.
Unit Price
Total Cost
A Ball Cap - Crossed Sticks - Stone   $16.95  
B Ball Cap - Crossed Sticks - Navy/Taupe   $16.95  
C Ball Cap - Shield - Navy/Red   $16.95  
D Ball Cap - Shield - Tan/Navy   $16.95  
E Ball Cap - Shield - Stone   $16.95  
F Ball Cap - Shield - Navy/Taupe   $16.95  
Souvenir Rubber Pucks   $4.95  
Payment Terms


Overseas orders accepted. Please note the shipping charges.

We do not accept VISA, MC, etc. at this time.

Send cheque or money order. U.S. and International orders (U.S. Funds). No phone order, mail order only.

Sub Total 
Shipping & Handling
(overseas substitute $10)
$4.00
Sub Total 
7% GST (Canada Only)
(Except NS, NB, Nfld.)
 
NS, NB, Nfld. residents add 15% HST  
GRAND TOTAL