Discount Avionics Submission Form

Please complete the form bellow and send in with your ELT.
Either type your information or write it in after you print it.

Note: Please reset the form to erase your data before leaving this page.

Please Select your the carier you prefer for shipping. If no carier is selected the default carier will be Canada Post

Discount Avionics is now offering the possibility for customers to add insurance to their parcels for shipping purposes. Any additional cost for insurance must be covered by the customer. Discount Avionics is not responsible for parcels that are lost by the carrier.  

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Discount Avionics Submission Form

Mailling address: Conv box 3635 Cochrane,Ontario P0L1C0
Physical address: 5 North shore Road Cochrane,Ontario P0L 1C0

Name / Company:
Address:
City:
Province or State:
Postal Code or Zip Code:

Phone:
E-Mail:
Aircraft Registration:
Purchase Order #:
Battery Change:	(Yes)     (No)                   Parcel Insurance	(Yes)     (no)
Shipping Carier:	DefaultCanada PostDicomPurolatorFedexLoomisLloyds Richards	Value $
Credit Card:	(Visa)   (Mastercard)
Card Number:
Exp:
CVV:
Notes:

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