Order Form
The following Order Form can be used to order any of our products.
Fields marked with a
red *
must be filled or the form will not submit.
Name:
*
Shipping Address:
*
Town/City:
*
Province/State:
*
[choose one]
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland & Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
--States--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Email Address:
Telephone:
*
Fax:
Country:
*
[choose one]
Canada
United States
Other
Postal Code/Zip:
*
Comments
Click on product name to view picture.
Product Name
Size
Price
Qty.
T-Shirt
...
L
XL
$11.95
Ball Cap
Adjustable
$9.50
Polo Shirt
XL Only
$19.99
Bucket Hat
One Size
$10.50
Method of Payment
...
Cheque
Money Order
PayPal
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© Mermaid Motel & Enterprises 2005. All rights reserved.
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577 Main St Yarmouth, Nova Scotia Canada B5A 1J6