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The Army, Navy & Air Force
Veterans in Canada

Kitshop
Line

Regalia Stores Order Form

6 Beechwood Ave., Suite  #2
Vanier, Ontario
K1L 8B4

Phone:  (613) 744-0222
Fax:  (613) 744-0208
E-mail: anavets@storm.ca


UNIT / L.A. / COMMAND NAME:

ADDRESS:

CITY:                                                          PROVINCE:                           POSTAL CODE:

PHONE: (            )                           FAX:  (            ) 

DATE OF ORDER:                               PURCHASE ORDER NO. / NAME:

PLEASE CIRCLE ONE:  PLEASE RUSH / NO HURRY

DATE REQUIRED:

 
STOCK NO. DESCRIPTION QUANTITY



























NOTES:

- Please print this form, fill it out legibly and fax or mail.
- We are working on an e-mail version of this form.