mail order form

Mail order form (this form can be filled online with your computer)

First Name
Last Name
Address

City
State: (US residents only)
Zip Code
State/Province: (Non-US residents only)
Country:
Phone (Optional)
E-Mail address to deliver ebook
Order Information
Please check on the package you would like to order:
Stretch marks or Cellulite Removal remedy ebook only $18.00	Full package $39.00 only applies to stretch marks removal remedy The ebook included

Shipping and handling (For full package only, N/A if you order the ebook only)	$12.95 For USA $14.95 For Canada $24.95 for all other countries
Total Amount Enclosed

Payment must be made in US dollars. Check orders will ship in 2-3 weeks. Orders made by money orders and bank drafts will be shipped within 48 hours.
Please print this form and send with your payment to: Jean's Skin Care, PO Box 660234, Arcadia, Ca 91066-0234 USA

The following sections please leave blank

Order No.	TPW
EMD. S. D.	RF