ORDER FORM CANADA
Billing Information
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ORDER FORM CANADABilling Information |
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 Customer Name | Personal
cheques are not accepted. International money orders in USD |
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Address | ||||
City Province Post Code | ||||
Phone E-mail | ||||
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If you are paying by credit card, please fill in the
following: O
MasterCard O Visa O
AMEX | ||
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Exact Name on Card: |
| Quantity | Item# | Description | Size | Unit Price | Total |
| RC101 | Ultramild Cleanser | 4 oz bottle | $25.00 |
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| RC102 | Moisturizer | 2 oz jar | $41.00 |
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| RC103 | Facial Gel | 2 oz pump | $41.00 |
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| RC104 | Serum | 1 oz bottle | $52.00 |
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| RC114 | Night Cream | 1 oz jar | $38.00 |
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| RC105 | Eye Cream | 0.5 oz jar | $39.00 |
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| RC106 | Strontium Calming Lotion | 2 oz pump | $38.00 |
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| RC107 | Strontium Soothing Spray | 4 oz spray pump | $34.00 |
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| RC108 | Sunscreen "30" 4 oz | 4 oz tube | $36.00 |
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| RC108 | Sunscreen "30" 6 oz | 6 oz tottle | $46.00 |
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| RC116 | Concealer #2 | 0.35 oz Compact | $36.00 |
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| RC116 | Concealer #4 | 0.35 oz Compact | $36.00 |
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| RC116 | Concealer #6 | 0.35 oz Compact | $36.00 |
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| RC116 | Concealer #8 | 0.35 oz Compact | $36.00 |
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| RC116 | Concealer #10 | 0.35 oz Compact | $36.00 |
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| RC116 | Concealer #12 | 0.35 oz Compact | $36.00 |
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| Sub-Total |
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| Postage | $6.00 | |||
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| Total |
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There are no handling charges
To order by mail in the US and Canada, print out this order form
You may also fax a filled-out form to 413-236-9541
To order by phone call 1-800-696-9791
