Dragon Vape Online Order Form

Quebec Residents Only

DO NOT REQUEST SHARE ACCESS, MAKE A COPY AND FILL IN FORM
NE DEMANDEZ PAS L'ACCÈS AU PARTAGE, FAITES UNE COPIE ET ​REMPLISSEZ LE
FORMULAIRE
TOP LEFT CORNER < FILE < MAKE A COPY

Please submit a form to web@canadianvape.com to place an online order.

Order Information:
Product Name Nicotine Colour/Size Quantity
Strength
Shipping Information:
Name

Email

Phone Number

Shipping Address

Shipping Address
#2 (Apt, Unit)

Postal Code

City

Province Quebec

Country Canada

Billing Information:
Name

Email

Phone Number

Shipping Address

Shipping Address
#2 (Apt, Unit)

Postal Code

City

Province Quebec

Country Canada
Shipping Notes:

1. If your order is under $50.00 (CAD) before tax, a $15.00 shipping fee will be
added to your order.
2. Orders exceeding $50.00 (CAD) after tax will qualify for free shipping.

Payment Notes:

1. Once you have received your invoice, payment can be sent through Email
Money Transfer (web@canadianvape.com)
2. We can accept debit/credit cards manually over the phone. Give us a call at
1-833-236-8273.