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Nature'sAlternatives.com • 15508 W. Bell Road, Suite 101-438 •
Surprise, Arizona 85374-2432
• Phone (877)-877-0747 • Fax (623) 321-9977
• E-Mail:
•
If you are ordering
by check, please ignore the credit card references.
For credit card orders, you must Agree to the
Terms
(Please Print)
See **Payment Method Below**
| Name (as it appears on the credit card) | ||
| Address Line 1 | ||
| Address Line 2 (optional) | ||
| City | State/Prov./Prefecture | Postal Code |
| Country (if not USA) | ||
| E-mail Address (needed for order confirmation) | Home
Phone ( ) |
Office
Phone ( ) |
| Credit Card Number with Security Code | Card (Visa, MC, Discover, Amex, Diners, Carte Blanche, JCB) | Expiration Date |
| Name of Recipient (if different, optional) | ||
| Shipping Address (if different, optional) | ||
| Shipping Address Line 2 (if different, optional) | ||
| City | State/Prov./Prefecture | Postal Code |
| Country (if not USA) | ||
For
a complete pre-printed order form CLICK HERE!
CLICK HERE
for Alternate Form for Colloidal Silver Generators Only!
| Item | Description | Quantity | Unit Price | Subtotal |
| S/H | Shipping and Handling | $6.00 | $6.00 | |
|
Comments:
|
TOTAL: |
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Shipping and Handling |
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USA |
International Shipping will be determined by Weight and Country at time of shipment. Please e-mail for final shipping charges. |
Thank you
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**PAYMENT METHOD**
Payment will only be accepted made
out to Scot Brown.
Please pay amount due in cash, check, or money order.
International orders payable in US Funds preferred
as a Money Order from your Post Office.
International Money Order also accepted. Please follow above note.
I have read and agree to the following terms:
- I understand that Nature'sAlternatives.com will be the name listed on my credit card statement.
- International Orders will be charged the cost of shipping in addition to the product cost.