Welcome to Nix 'n Nax Corp.

Thank You for choosing your products from:

Corp.

A Canadian Company

Customer Information

* Name
*Address
*City
Prov/State*
* Postal Code/Zip
* Country
* Phone	-
Fax	-
* E-Mail
	*Required Information

Order Information

Please enter product code as shown in lower case.

* All Prices Are In Canadian Funds *

Code Number
(specified in red) Product Name
Quantity
(eg.500ml. or 1 candle, Etc.)

1

2

3

4

5

6

7

8

9

10

* Additional forms are needed if more than 10 items are ordered. Shipping costs will be calculated on the order and you will be notified via e-mail.*

* You may print this form for your reference.*

Special Requests about your order

Eg. C.O.D (within Canada), Carrier of your choice, Etc.

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