Date of Order: PO # Page: of
Date Required By: Contact: Company:
Phone: Fax: E-mail:
Backorders?  Yes  No
(Some backorders will be consolidated)
Preferred Shipping (UPS or Canada post):
Mailing Address:
Shipping Address:
Item Number Qty Description Remarks

All accounts are net 30 days for payment

Please fill out and then print this form and fax it to Map Town

100 - 400 5 Avenue SW, Calgary, AB T2P 0L6
Toll-free (877) 921-6277 | Tel (403) 266-2241 | Fax (403) 266-2356