Coast Rocketry Order Form
7446 209A Street, Langley B.C. Canada. V2Y 2E4 Phone (604) 530-5411 or Fax (604) 530-7447.
Print out this page, and mail or fax it to Coast Rocketry. All order information will be kept in confidence for Coast Rocketry and will not be passed on to any other parties. Coast Rocketry will calculate all applicable taxes and shipping charges and will then contact you, usually by phone for your approval. Orders are paid by credit card or money order are normally shipped next working day.
Name: First: Last: E-Mail:
Home Address (required if not a business): Street: City:
Province / State: Postal Code / Zip:
Phone numbers including area code: Home (required if not a business): Business:
Shipping Address if Different Street: City:
Province / State: Postal Code / Zip:
| Quantity | Item Number | Description | Unit Price | Total |
Coast Rocketry will add all applicable taxes and shipping charges and will then contact you, usually by phone for your approval. |
Sub Total |
$ |
Payment Method: (please circle one) Visa / MasterCard / Money Order
Full Card Number: __________ - __________ - __________ - __________ Expiry Date: month ________ year ________