Order form for Greenpeace Cheques

Simply click "PRINT THIS ORDER FORM" at the bottom of the page to print out your order form.
Fill in all fields and mail to the address below.
If you do not have a printer to print the form,
follow the instructions below and make your request
very clear on a handwritten sheet.

Mail the re-order form OR a sample VOID cheque and a payment cheque to:

Federated Cheque Services
P.O. Box 1381, Osoyoos B.C. V0H 1V0

If you have any questions please call Toll Free: 1-800-797-9896
VERY IMPORTANT!.........Please put a checkmark in one of the following boxes.

PLEASE PRODUCE MY ORDER AS I HAVE INDICATED

AS SAMPLE, NO CHANGES
 AS SAMPLE WITH CHANGES I HAVE INDICATED
AS THIS FORM IS FILLED OUT
NAME________________________________________________________________________________
ADDRESS ___________________________________________________________________________
CITY ___________________________________ PROVINCE ______________________________
POSTAL CODE __________________________ TEL ____________________________________

PRICES FOR CANADIAN PROVINCES

Effective July 1, 2010

B.C. RESIDENTS ON, NFLD, NB, NS RESIDENTS ALL OTHER PROVINCES
$33.90 $34.90 $33.40
Total PER 200 Cheques Total PER 200 Cheques Total PER 200 Cheques
ABOVE PRICES INCLUDE APPLICABLE TAXES, SHIPPING AND HANDLING
I am ordering ______________ set(s) of Greenpeace Cheques
The total of my order is (____________ )order(s) x______________ =__________________
Please start my cheque numbering at #_________________
BUSINESS CHEQUES WITH STUBS OR DUPLICATE (NCR) CHEQUES ARE NOT AVAILABLE.
DELIVERY TIME IS 2-1/2 - 3-1/2 WEEKS.

Print this Order Form

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