The Coffee Shop
U.S. & International Order Form
Simply print out this form, fill in the fields below then fax it to 1.604.948.5413
or mail it to: DecentCoffee.com, 5186 11A Avenue Delta, B.C. Canada V4M 3W3
Item
Description
 
Price (U.S. $)
Quantity
Subtotal (U.S. $)
Click on item numbers for more information.        
# 1101 The Decent Coffee Cosy 1.0 litre  
$13.00
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________

# 1102
The Decent Coffee Cosy 1.5 litre  
$15.00
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________
Click on item numbers for more information.
To ensure a proper size cosy for your bodum, read our FAQ page.

We accept Visa, Cheques and International Money Orders.
30 Day Return and Exchange Guarantee
Shipping:
$5 for each Cosy
________
TOTAL (U.S. $)
________
Name:
___________________________________________________
Address:
___________________________________________________
City:
___________________________________________________
State/Prov:
___________________________________________________
Country:
___________________________________________________
E-mail Address:
________________________
Zip/Post. code: _______________
Telephone no:
________________________
Method of Payment:
Money Order     Visa   Cheque
Expiry date: _______________
Visa No#:
_______________________________
Name as it appears
on credit card.
_______________________________

Thank you
for your order!