Order Form
      Fill out this form and mail to address below
    Organization:
    Fire Department Name:
    Contact Name:
    Address 1:
    Address 2:
    Phone:
    E-Mail:
    Web-Site:

    Product Packages  Description  Price  Order ? 
    Bronze  English  $1,895.00  Yes  No 
    Spanish  $1,895.00  Yes  No 
    English and Spanish  $2,495.00  Yes  No
    Silver  English  $1,895.00  Yes  No 
    Spanish  $1,895.00  Yes  No 
    English and Spanish  $2,495.00  Yes  No
    Gold  English  $1,995.00  Yes  No 
    Spanish  $1,995.00  Yes  No 
    English and Spanish  $2,595.00  Yes  No
    Grand Total: 
Method of payment: U.S Fund only Check, Money Order or Purchase Order

Payable to: Online P2000
71 John Walter Cres, Courtice, ON, L1E 2W7, Canada

For all packages, please attach a 3.5" diskette with a copy of your fire department patch along with your order. Save as Type JPEG(*.jpg)