Domaine Label and Trim Inc.

1130 rue Beaulac
St-Laurent, Quebec H4R 1R7
Phone (514) 908-5686, Fax (514) 908-5687

First time customer?   Please follow this link contact us to set up an account or to inquire more information on our products.

Regular customer?   For your convenience, please take the time to fill the order form below.   All information must be entered before the form can be submitted. All fields marked with a "*" are required input (use the tab key or mouse to go to the next field):

*INVOICE TO:

Company Name:
 E-Mail:
Address:
 City or town:
Province/State:
 Postal/Zip Code:
Phone(with area code):
 Fax(with area code):

SHIP TO (if not same as invoice address):

Company Name:
 E-Mail:
Address:
 City or town:
Province/State:
 Postal/Zip Code:
Phone(with area code):
 Fax(with area code):

Your Customer ID #:

*Customer Purchase Order:

*Delivery Date Requested:
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Payment Method:

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Comments:

Item #

Description

Quantity

Price

Amount
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Key Contact:

Robin Stark

Email:

robin@domainelabel.com