Document Retrieval & Reference Report
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Please print off this order form and mail it with your payment (check or money order payable to Upper Canada Genealogy) to: Upper Canada Genealogy, Suite 2807, 33 Isabella Street, Toronto, Ontario, Canada, M4Y 2P7.
CUSTOMER INFORMATION
Name: _____________________________________________
Street Address: ______________________________________
City: __________________________________
Province/State: ______________
Country: _______________
Postal Code/Zip Code: ___________
E-mail address (to confirm receipt of your order): _________________________
Telephone number (with area code): _________________
ORDER DETAILS
| Please refer to your index search report for the document number (if ordering a document) or report number (if ordering a reference report) |
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Sub-total: |
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_________ |
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Subtract Discount * |
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Add 6% GST ** |
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Total Amount Enclosed: |
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