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ORDER FORM
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Invoice and Shipping Information
Your Name -
Your Address -
Your Address - if additional space is needed
City or Town -
State or Province -
Zip Code or Postal Code -
Area Code and Telephone Number -
Your E-mail Address -
Please Repeat E-mail Address -
From Drop-down Menu (Choose)
a) Number of Switches
b) Style & Colour of 1st Switch
c) Style & Colour of 2 nd Switch
disregard this box if only ordering one
Note if Ordering two (2) switches
You may order one toggle and one decora or both the same
You may order them the same color/colour or different colors/colours
Take Advantage of the Discount for two (2) switches and the one time shipping & handling cost:
One idea to order a second for a friend and split the cost, or
If you have porchlights in more than one location controlled by separate switches or
Purchase the second for a family member as a gift.
Promotional Code:
Please enter your promotional code here
Any Addition Comments or to Inquire
about ordering for a club or group,
Please enter you comments in this box >
1 switch
2 switches
$ 59.95 + $7.00 S&H
$ 109.95 + $7.00 S&H
Required Fields
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Credit Card Customers are processed with PayPal - when completed, click on the < Submit Order > button and you will receive a PayPal Invoice via e-mail usually within 48 hrs expect weekends and holidays.
Check/Cheque and Money Order Customers - print form
and when completed, by selecting the < File > drop-down menu
in the top left corner of your tool bar and by using the < Print >
option. Mail printed form with Check/Cheque/Money Order to:
