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Fax / Mail Order Form |
Please print this form out and mail or fax to the address below.
| Ship To: (Sorry, no P.O. Box delivery) |
| Name: |
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Street Address: |
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City: |
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State: |
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Zip: |
| Phone: |
| Fax: |
| Email: |
| Product No. | Description | Bottle Size | Price Each | Quantity | Total Price |
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Subtotal |
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CA Residents add (8%) |
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Check below for Shipping Charges |
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Order Total |
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| Standard Mail / UPS | Express Mail (3 day) | International
(Air) All applicable duty, custom charges and taxes are paid by the recipient. |
|
| Orders under $30 | $5.00 | $13.00 | $17.00 |
| $30 - $99 | $6.00 | $16.00 | $21.00 |
| $100 - $199 | $7.00 | $19.00 | $25.00 |
| $200 - $299 | $8.00 | $22.00 | $29.00 |
| Over $300 | $8.00 flat rate |
29.00 flat rate | $29.00 Flat rate |
If you desire more products,
please reprint this page or make additional copies of original if
you wish to make a purchase by check or money order please make them out
to:
ULTIMATE VITAMINS
369-B Third Street #316
San Rafael, CA 94901
Phone: 415/ 289-2279
Fax: 415/ 457-5203
Email: orders@ultimatevitamins.com
Method of Payment: (sorry, no C.O.D. orders)
| Charge To: (please check box) |
|
Mastercard |
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Visa | |
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Money Order | |
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Personal Check | |
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Official Bank Check |
Important Information for Credit Card purchases.
Account Number (all digits):
______________________________________
Expiration date
_____________________________________________________
Signature Required if using Credit Card