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Mar-Lift Order Form
Phone:
1-877-892-0901 (toll free)
613-692-4181 - Day 7:30 AM to 5:00 PM EST
613-692-2794 - Evenings/French speaking 7:00 PM to 9:00 PM EST
Fax:
613-692-0760
Address:
Majestic Auto
6204 First Line Road
Kars, ON K0A 2E0
CANADA
Make check or money order payable to Majestic Auto.
Items Ordered
Brake Winch Mar-Lift:
Wheel Kits with Lock:
Half Mar-Lift:
Wheeled Dollie:
Adaptor Kit:
Currency:
Canadian
U.S.
*
- Fields that must be filled out.
Name and Address
*
Name:
*
Address:
Shipping Address:
(if different than address)
*
Phone Number:
(Day)
Phone Number:
(Night)
*
City:
*
State/Province:
*
Zip Code/ Postal Code:
Method of Payment:
Credit Card
Check (Cheque)
Money Order
Type of Card:
VISA
MasterCard
AMEX
Credit Card Number:
Expiry Date:
(mm/yy)
Cardholder's Name: