ORDER FORM

Jasmines Sanctuary

Box 314,

Chalk River, Ont.

K0J 2J0

613 970-6628

Customer Service: 1-613-970-6628 Monday to Friday 9 am to 5 pm

Your name: ______________________________________

Street Address:____________________________________

City:____________________________________________

Zip Code/Postal Code: _______________________________

Telephone: _______________________________________

Email address: ____________________________________

Describe what products you are ordering, the amount and the price.

Price depends on product.

Shipping and handling and taxes are extra.

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