Hoppy DVD Order Form

HOPPY

T-Shirt & DVD Order Form

Canadian Customers

Please PRINT and MAIL this form along with your payment to:

Tony Girardin
4825 St-Roch Nord
Drummondville, Quebec
J2B 6V4

QTY	ITEM	PRICE	Total

_____	Hoppy T-Shirt & DVD	$35.00	_________

_____SMALL	_____MEDIUM	_____LARGE	_____XL

* Prices in Canadian Dollars *

Shipping Information

Name _________________________________________________

Address _______________________________________________

City _______________________________ Prov ______________

Postal Code ________________ Phone # ___________________

Email _____________________________

Please Attach Paymento this form

We can accept personal cheques, money orders, bank drafts and certified cheques. With personal cheques, please understand that we must wait until the funds clear the bank before we can ship out your order. Money orders, bank drafts and certified cheques will guarantee immediate shipping.

Please allow 6-8 days for delvery.