Order Form - Aqua Blue Water & Filltration

Please submit your bottled water order on the order form below. If you need products which are not listed in this order form, then please call our store at 604-339-5040.

IMPORTANT: Your order will be delivered at your next delivery date. You can view your next delivery date by using the map to the right of this form. Click on one of the colored zone to view the schedule dates for that particular zone. You can order days in advance but no later than 8am on your scheduled delivery date.

Name*
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Company
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Street Address City
There is a minimum order of 3 bottles per delivery.
To view the upcoming delivery in your region, simply click on your location on the map to the right.
Water (Mineralized Alkaline / Demineralized)
Number of 18.9L bottles of demineralized water. $7.50
Number of 11.3L bottles of demineralized water. $7.00
Number of 18.9L bottles of Himalayan alkaline mineralized water. $8.50
Number of 11.3L bottles of Himalayan alkaline mineralized water. $8.00
Additional Products
Number of sleeves of 5 oz. Plastic cups (100 per sleeve) $6.99
Number of Cases of 5 oz. Plastic cups (2000 per case) $118.85
Number of H2OK Water Cooler Cleaner Kits $9.95
Additional Notes

There is a minimum order of 3 bottles per delivery.