Purchase Order Form
INNOVA Multimedia Ltd.
P.O. Box 20020
Stephenville, NF
A2N 3R8
1-877-846-6682 (Toll-free)
tel (709) 643-3026
fax (709) 643-3126
innova@INNOVAMultimedia.com
INNOVAMultimedia.com

Bill to Information
Name:
Title:
School:
Address:

Telephone:
Fax:
E-mail:
 Ship to Information
Name:
Title:
School:
Address:
Purchase Order
Product Quantity Unit Price Total
       
       
       
       
       
       
       
       
       
 
Taxes:

NB, NF, NS: HST - 15%
Remainder of Canada: GST - 7%
(outside Canada No Tax)		 Shipping:

Orders under $100.00: $5:00
Orders over $100.00 5% of the subtotal.		 Subtotal  
Tax
(see table on left)		  
Shipping
(see table on left)		  
Total  
Purchase Order Information
Purchase Order Number:
Authorized Signature:		 Credit Card Information
Visa or Mastercard (Circle one)
Card Number:
Expiry Date:
Name on Credit Card:
Authorized Signature:

*Please Print and Fax