Enter your details and information in the form below to process payment.

    Personal Details

    Your First Name (required)

    Your Last Name (required)

    Your Email (required)

    Phone Number (required)

    Billing Address

    Street Address

    City (required)

    Country (required)

    Province (required)

    Postal Code (required)

    State (required)

    Zip Code

    Different Shipping Address?

    Shipping Address (Only fill out if different from billing address)

    Street Address

    City (required)

    State/Province (required)

    Postal/Zip Code

    Pad Details:
    Need to see the colors again? See them here!

    Top Color:

    Bottom Color:

    Quality:

    Purchase Details

    Enter the quoted amount below:

    Total Amount to be charged including taxes

    (if '0' is displayed you may have to click into the field to calculate taxes.
    *Also, please note that in some rare cases, the taxes may not calculate. If this happens to you, please continue to fill out the form and we will confirm the amounts with you via email or phone afterwards*)

    Comment/Message

    *WE WANT TO MAKE SURE YOU GET A WELL FITTING PAD.
    We will call all orders placed online to make sure the measurements were done correctly. If we require a pattern of your table, we will mail you a pattern paper.

    0