Breakfast By The Lake

Order Form

Mail or Fax to:

By The Lake Bed & Breakfast
86 Grandview, Westerose,
Alberta T0C 2V0

Fax: (780) 586-3829

Please send me:

______ copies of "Breakfast By The Lake" at $10.28 each $_______

Plus $2.00 per copy for mailing $_______

Subtotal $_______

Plus GST @ 7% $_______

Total $_______

Method of payment:

Name on Card___________________________

Visa # ____ ____ ____ ____ Expiry Date: __ / __

Cheque # _________

Signature:________________________________

Name:
_______________________

Street:
_______________________

City: _______________________

Province: _______________________

Postal Code: ________

Return to Gift Ideas Page

______ copies of "Breakfast By The Lake" at $10.28 each	$_______
Plus $2.00 per copy for mailing	$_______
Subtotal	$_______
Plus GST @ 7%	$_______
Total	$_______

Name:	_______________________
Street:	_______________________
City:	_______________________
Province:	_______________________
Postal Code:	________