APEGGA Specialty Products Order Form

APEGGA Specialty Products
........................................................................................................ Order Form

Special promotional products for APEGGA members' use. Order your supplies today.
(This form is not secure at the moment, if you prefer please call Bronwen Stembiski at
(780) 426-3990 with your visa number.)

Click on each specific item for larger photo.

	Description	Unit Price*
	Golf Shirt (picture not avail.) Sizes: M, L, XL, XXL	$45.00
	Travel Mug	$32.00
	Clock	$32.00
	Coffee Mug	$ 8.00
	Computer Paper Holder	$ 4.50
	Lapel Pin	$ 3.00

Item No. & Size:	Unit Price:	Quantity:	Subtotal:






	Includes Shipping & GST:
	Total Due:

Mr. Mrs. Ms. Miss

First Name:		Last Name:

Member No.:
Mailing Address:
City:		Province:

Postal Code:
Email:
Telephone:
Credit Card:	Visa Mastercard
Credit Card No.:		Expiry Date:

Or mail to:
The Association of Professional Engineers,
Geologists and Geophysicists of Alberta (APEGGA)
1500 Scotia One, 10060 Jasper Avenue
Edmonton AB T5J 4A2

Fax to:
(780) 425-1722

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