Links Direct Purchase Form

Online Gift Baskets
Local "Orders Direct" Purchase Form


Business Information:
Business Name:
Incorporated : Yes No
Street Address (Line 1):
Street Address (Line 2):
City:
State/Province:
ZIP/Postal Code:
Country:
Telephone:
Fax:
Cellular:
E-mail Address:
Website Address:
GST Registration # (Canada & Australia Only):

Operator Information:
First Name:
Last Name:
Street Address (Line 1):
Street Address (Line 2):
City:
State/Province:
ZIP/Postal Code:
Country:
Telephone:

Business Partner Information (If Applicable):
First Name:
Last Name:
Street Address (Line 1):
Street Address (Line 2):
City:
State/Province:
ZIP/Postal Code:
Country:
Telephone:



ORDERS DIRECT CITIES
Primary City (Indicate Where your business is located) - CA$119.95 Plus 5% tax (Annual not monthly)

Optional Secondary Cities (Indicate your choice of nearby cities that you "hand" deliver to next business day) - First 3 are free, each additional CA$5.95 Plus 5% tax (Annual not monthly)













Credit Cardholder Information:
First Name*:
Last Name*:
Company (*If Applicable):
Address*:
City*:
Province/State*:
Country*:
Zip/Postal Code*:
Phone Number*:
E-Mail Address*:

Method of Payment:
Payment Type:
PayPal Account (If Applicable):
Cardholder's Name (As It Appears On The Card):
Card Number: - - -
Card Expiry:
Credit Card Code (CVV2/CVC2/CID):
Please Read and then indicate that you Understand & Agree To Our Links Direct Terms & Conditions? (yes/no):
A receipt for your "Links Direct" payment will come to you by email