INFORMATION ORDER FORM

For more information regarding our services, please fill in this form. Fields with an * must be filled out. We look forward to hearing from you.

* First Name:
* Last Name:
Title:
* Business Name:
Street Address:
Address (cont.):
City:
State/Province:
Zip / Postal:
Country:
Phone:
Fax:
* E-mail:
Type of Store:
Type of Sale:	Wild Weekend Sale
	Promotional Sale
	Closeout Sale
Inventory at Cost:	Select from the list $10,000 - $49,999 $50,000 - $99,999 $100,000 - $249,999 $250,000 - $499,999 $500,000 - $999,999 $1,000,000 +

a: 2349 Fairview Street, Suite 415, Burlington, ON    |    p: 1.800.363.2656    |    e: info@taylormartin.com