Interval Timing Canada
Box 206
Stettler, AB TOC 2LO
(403) 742-8030 ph
(403) 742-5627 fax
INTERVAL TIMING REPORT
ORDER FORM
Print/hard copy order forms available at upcoming events as well.
Name________________________________________ Mail_____
Address______________________________________ Email_____
_____________________________________________ Fax_____
Fax#__________
_____________________________________________ Pickup_____
Phone #_________________
Payment by: Cash__________ Cheque__________
Credit Card:
VISA__________M/C__________ AMEX__________
Card# ________________________
Date & Race
Name_____________________________________________________
Horse__________________ Draw#_______ Horse_________________ Draw#_______
Rider______________________________ Rider______________________________
Date & Race
Name_____________________________________________________
Horse__________________ Draw#_______ Horse_________________ Draw#_______
Emailed orders via the
internet will not be shipped until paid for.
Reports: $10./each TOTAL:__________
OFFICE USE: PAID_______ SHIPPED_______ BY_______ DATE_______
Please note that credit card receipts will include this name:
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