| Fax / Mail Order
Form (Requires Printer) To Print this form, use your browser's "print" button. Please, make checks payable to iNatural Cosmetics and mail with the Order Form for fulfillment to: Beauty Realm 6189 Barbara Street Jupiter, Florida 33458 If you wish to pay by credit card, follow directions below. |
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| Please, accept my order (Delivery Time 5-6 Business Days) for: | ||||||
| Description | Item | Quantity | Unit Price | Total $ US | ||
| 1. | # | : | $ | $ | ||
| 2. | # | : | $ | $ | ||
| 3. | # | : | $ | $ | ||
| 4. | # | : | $ | $ | ||
| 5. | # | $ | $ | |||
| 6. | # | $ | $ | |||
| 7. | # | $ | $ | |||
SHIPPING & HANDLING: INTERNATIONAL CUSTOMERS - CLICK HERE |
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| Sub-Total | $ | |||||
| Florida Sales Tax 6% (If applicable) | $ | |||||
| TOTAL DUE (Charge Amount) | $ | |||||
| Please, provide sufficient information so that we may properly process your order without delay. | ||||||
| First Name | ||||||
| Last Name | ||||||
| Company | ||||||
| Street or P.O. Box | ||||||
| City | ||||||
| State | ||||||
| Zip | ||||||
| Country | ||||||
| Telephone | ||||||
| FAX | ||||||
| E-Mail Address | ||||||
| PAYMENT
INFORMATION: We accept Visa, Mastercard, American Express and Discover Card; or mail your Check / Money Order payable to:
If you are paying by credit card, you may send your order by fax or mail. Our fax number is: 561-748-9916. For additional information, please telephone: 561-847-5400 |
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| Cardholder Name | ||||||
| Credit Card Number [Visa, MC, Discover, Amex] | ||||||
| Expiration Date | ||||||
| Signature (FAX or Mail Orders): | ||||||
| Comments & Notes: | ||||||
Thank You for Your Order! |
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