PRODUCT ORDER FORM
| P.O. Box 3749, Batesville, Arkansas 72503 |
Telephone Orders: 800-572-8446 or
870-698-2311 Fax Orders: 800-959-2777 or 870-698-2379 |
| Regular Business
Hours: 8:00 am to 10:00 pm Central Time Monday - Fri Saturday 9:00 am - 5:00 pm Orders May Be Placed Electronically 24 hours, 7 Days a Week. Effective Date September 1, 1999 |
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INSTRUCTIONS |
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Select the items you desire to order. List them on this page, including quantity, item numbers and other pertinent information. Total the shipping weights and charges (shipping rates are listed in the box below). Then, add your local sales tax and total the amount of your order. (Feel free to call us for your total price, see phone numbers above.) |
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MEMBER INFORMATION
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| NAME | PIN NUMBER | DATE | |||
| PHONE | S.S. No. or Fed ID No. |
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| STREET | CITY | STATE | ZIP | ||
| SHIP TO STREET (if different from above) |
CITY | STATE | ZIP | ||
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LIST ITEMS TO ORDER HERE
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| Qty. | Product Number |
Item | Package Size |
Shipping Weight (OZ) |
International Point Value (IP) |
Price Each |
Total Amount |
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1950 |
Proanthenols HP with 100 mg Masquelier'sŪ OPC |
60 |
4 |
40 |
US $45.50 |
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1950 |
Or, Buy 6 get the 7th bottle FREE! |
7x60 |
28 |
240 |
US $273.00 (save $45.50) |
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SUBTOTAL | $ | |||||||
| SHIPPING | $ | ||||||||
| SALES
TAX (For Your Area) |
$ | ||||||||
| TOTAL | $ | ||||||||
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