Order form
Print it, fill it out and send it to us by e-mail.
Wherever you live, you can reach Hironbec at 438-376-3068 or 514-715-8570.
- Print this form once you have filled it out.
- Send it by e-mail to info@hironbec.com, or by mail to the address below.
21-2, rue St-Laurent
Beauharnois (Québec) Canada J6N 1V1
Tel.: 438-376-3068 or 514-715-8570
Your contact information
Please print in block letters.
| Date | |
|---|---|
| Name and first name | |
| Address | |
| City | |
| Province or state | |
| Country | |
| Postal code | |
| Phone |
Your order
| Item | Qty | Description | Price |
|---|---|---|---|
| Shipping costs | |||
| TOTAL | |||
No taxes apply to any of our products. Shipping is not included: it is determined when the order is placed, based on the items ordered and the destination.