Investors Source - Order Form
Print this form, pay by Credit Card and fax to: Fax #: 1-866-210-3533 or
Pay by check and mail to:		Investors Source Corp.- 35 Clapperton St. Barrie, Ontario L4M 3E6
Please e-mail any questions you may have to: admin@investorssource.com, or call (705) 734-1541
Product:
Quantity:		Notes
		($450.00 Wealth Creator - One time first year license per user)
		($350.00 Wealth Creator - Annual License Renewal per user)
Unit Price:		($150.00 Additional License - Annual per user)
5% GST		(Canada Only)
8% PST		(Ontario Only)
13% HST		(NB, NS, NFL Only)
Total:
Company Name:
Users Name:
Street:
City:
Province/State:
Postal Code:
Country:
Phone #:
Fax #:
E-mail:
Payment Method:
Card Number:
Expiry Date:
Name On Card:
Signature:
The issuer of the card identified on this form is authorized to pay the amount shown as total upon proper presentation. I promise to pay such total (together with any other changes due thereon) subject to and in accordance with the agreement governing the use of such card.