Fax Order Form for SlenderWrap weight loss and body wrap products

Pricing

Items marked in red indicate a sale item !!!

Qnty		Price	Subtotal	Qnty		Price	Subtotal
	Bandages				Cellulite Reduction Cream
	1 Dozen Wraps	48.			4 oz. Jar (30 day supply)	29.
	Chin Compression Wrap	14.			8 oz. Jar (60 day supply)	49.

	Sea Clay Mud				Sauna Suits (Heavy Vinyl)
	4 oz. Jar (2 Partial wraps)	29.			Small 26"-30"	35.
	8 oz. Jar (4-5 partial wraps)	49.			Medium 30"-34"	35.
	Gallon (40-50 Full wraps)	299.			Large 36"-40"	35.
					XL size 42"-46"	35.
	Chin/Neck Contour Cream				XXL size 48"-54"	39.
	2 oz. (45 day supply)	17.			XXXL size 56"-62"	45.
	4 oz. (3 months supply)	29.
	8 oz. (6 months supply)	49.			Shipping Method (choose 1)
					UPS Ground (2-5 business days)	7.95
	Combinations				2nd Day Air (2 business days)	15.95
	2 oz. chin cream + chin wrap	29.			Overnight (next business day)	35.95
	4 oz. chin cream + chin wrap	39.
	8 oz. cream PLUS 2 chin wrap	69.			Subtotal Column	B--->
	Total Column A ---	----->		---->	Subtotal Column	A--->
					Grand Total	----> $

Payment Policy and shipping terms:

For Credit Card and Money Orders: Orders will be shipped the day they are received, if before 2:PM Eastern Standard Time. Remember that UPS considers "business days" when delivering. Example: Order before 2:PM on Friday, delivery requested is "2 day air". Receive your order on Tuesday.

Business and Personal Checks: We can not accept personal or business checks. We will accept Cashier's or certified checks.

Order By Mail: SlenderWrap, Inc. 8125 Halyard Way, Indianapolis Indiana 46236

Order By Fax: (317) 823-8049

Billing Address:

Name on credit Card _____________________________________ Phone ( ) ______________

Billing Address ______________________________Apt. _____ is this a residence? Yes___ No___

City _____________________________ State______________ Zip ___________

Shipping Address: Leave blank if same as above

Street ____________________________________ Apt.______ is this a residence? Yes___No____

City ____________________________ State_______________ Zip ____________

special instructions? ______________________________________________________________

Authorization for Credit Cards

MasterCard or Visa # only ______________________________________ expires _____/______

I authorize the amount of $_____________ to be charged to the MC/Visa or Debit Card listed above, and acknowledge there is no refund on items that are returned that have been opened. No refund is allowed on Sauna suits, bathing suits, underwear, or compression garments under Indiana State Law. I affirm that I am an authorized user of this account.

Signature __________________________________________ Date: _________________