Please fill in this order form and send it to the address below, along with a pencil tracing of both feet. Please ensure that you are sitting in a chair, with weight on your feet, as you outline each bare foot on a sheet of paper. Also, include your normal shoe size.

In Canada - $110 + $15 (S + H) = $125 Cdn.

In U.S.A. - contact us for pricing .

Please ship __________ pair(s) of Powerfirm weightlifting shoes, model ___________________________
to the following address:


Name: ______________________________________________________________________________

Address: ____________________________________________________________________________

City/Town: ___________________________________________________________________________

Country: ____________________________________________________________________________

Postal/Zip Code: ______________________________________________________________________

Telephone No: _______________________________________________________________________

E-mail address: _______________________________________________________________________

Shoe model preference: ________________________________________________________________

Normal shoe size: _____________________________________________________________________

Your weight (opt): _____________________________________________________________________

TO:

POWER FIRM
35 SHERBO COVE
WINNIPEG, MANITOBA
CANADA, R2C 5L8

A certified cheque or money order in the amount of $___________ payable to Power Firm, is enclosed, representing payment in full for ________ pair(s), taxes, shipping and handling included.