Kelowna Pouches Order Form

Kelowna Pouches Order Form
Same Day Delivery

CASH ONLY

$15.00 EACH

FREE DELIVERY 5+ CANS
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STW: Spearmint - 6mg
$15.00CAD Quantity
Item subtotal:$0.00CAD



STW: Grape - 6mg
$15.00CAD Quantity
Item subtotal:$0.00CAD



Velo: Ice Cool - 10mg
$15.00CAD Quantity
Item subtotal:$0.00CAD



Velo: Polar Mint - 14mg
$15.00CAD Quantity
Item subtotal:$0.00CAD



Velo: Max Freeze - 17mg
$15.00CAD Quantity
Item subtotal:$0.00CAD



ZYN: Fresh Mint - 6mg
$15.00CAD Quantity
Item subtotal:$0.00CAD



ZYN: Cool Frost - 9mg
$15.00CAD Quantity
Item subtotal:$0.00CAD



ZYN: Cool Blueberry - 11mg
$15.00CAD Quantity
Item subtotal:$0.00CAD



ZYN: Icy Blackcurrant - 12.5mg
$15.00CAD Quantity
Item subtotal:$0.00CAD



ZYN: Cool Mint Ice - 16.5mg
$15.00CAD Quantity
Item subtotal:$0.00CAD



Total

$0.00CAD
Number of Cans in Order
Subtotal
Order Total (With Discounts)
CASH ONLY - Total is rounded to nearest $5
SELECT AT LEAST 3 CANS TO CONTINUE ORDER

NOTE: If the minimum order requirement is met but the form is not updating, please re-select one of the products to fix the form.

NOTE: FREE DELIVERY 5+ CANS
Delivery Method*

Free DeliveryFree Pick Up
Delivery Method*

$10 DeliveryFree Pick Up
Order Total
CASH ONLY - Total is rounded to nearest $5
Delivery/Pick Up Date*

MonthDayYear
Date
Delivery/Pick Up Availability (We will contact you to confirm exact time)*

Early AfternoonLate AfternoonEarly EveningLate Evening
Full Name*

First NameLast Name
Phone Number*
E-mail*
Address

Street Address

CityProvince

Age Verification*

I am 19 years of age or older.
Order Profit
Order Total
CASH ONLY - Total is rounded to nearest $5
PAYMENT IS CASH ONLY

We will contact you to confirm your order and delivery time.
Should be Empty:

NOTE: FREE DELIVERY 5+ CANS