Return to Order Form instructions.

Leatherique Canada
388 Lakeshore Road RR #5
Niagara on the Lake, Ontario
L0S 1J0
Tel: (905) 937- 2159
Fax: (905) 937- 8196
email: leatheriquecanada@computan.on.ca

Name:

Shipping Address


Street Number - Street Name - Apt #


City, Town or Village - Province - Postal Code


Phone Number (required for courier) - Email Address

Please fill in the product name, volume, quantity and price.
All dyes are custom mixed and are not returnable or refundable.

Product Name
Size (e.g. 16 oz.)
Quantity
Unit Price
Amount ($)


ORDER TOTAL $ :(Plus applicable taxes and shipping.)

Delivery can be by courier or post. Please contact us for a rate quote.
(For courier, someone must be available to recieve the package between 9 am and 5 pm)

Method of payment

card number: Expiry Date:

Name on Card:

Comments:

For Pay Pal, send us this form and we will reply with your total including tax and shipping.
Then, through Pay Pal, find us at leatheriquecanada@computan.on.ca

Thank You