Fax Order Form

Please fill and click the print button to print this order form and fax it to: 1 (604) 323-1150

First Name: Last Name:

Shipping Address (physical address):

Number: Street: City:

State: Zip Code: Country:

Telephone: Cell phone

E-mail:

Credit Card # Expiration Date /
Name on CC:

I would like to order the following items:
(Please write your order below. You will be charged for shipping charges and local
taxes, if applicable. Shipping cost will be equal to the cost showing on our website.

- All products are shipped from Canada, via Canada Post.
(Please note charges billed for Fax order will appear under the name of
Casual Furnishing Ltd, Winnipeg"

Your Signature: ( after print, sign and fax)

( As shown on your card)

Inhairit Natural Solutions,
734 E 55 Avenue, Vancouver, V5X 1N7, Canada
Tel: 1 (604) 323-1150, Email: inhairit@inhairit.com