WESTERN CANADA'S LARGEST LIGHTING DISTRIBUTOR
REGULAR ORDER FORM
Simply fill in the form below and one of our representatives will contact you shortly to confirm and give you the total price for your order. You may also contact us through one of the phone numbers listed in the
"Branches"
section
COMPANY NAME
STREET ADDRESS
CONTACT NAME
CITY
PHONE NUMBER
PROVINCE
British Columbia
Alberta
Manitoba
New Brunswick
Newfoundland
Nova Scotia
Northwest Territories
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
FAX NUMBER
POSTAL CODE
E-MAIL ADDRESS
Please fill in these fields to the best of your ability. Keep in mind these guidelines when identifying a lamp:
Wattage
(or candle power)
Voltage
(or amps)
Shape of Glass
(look at lamp identification guides)
Type of Base
(look at lamp identification guides)
Maximum Overall Length
(measurement from tip of glass to end of base)
Diameter
(size of glass at widest point)
Use of Lamp
(microfiche, display, projector, etc.)
Other
(identifying marks or printing on the glass or base)
Manufacturer
Graphical Lamp Guides (only for picture capable browsers)
Incandescent and Halogen Lamp Guide
Compact Fluorescent Lamp Guide
Fluorescent Lamp Guide
ITEM NUMBER
DESCRIPTION
Individual
PIECES
to buy
ADDITIONAL COMMENTS/INFORMATION
