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SHIP
TO
NAME
ADDRESS
APT/FLOOR/SUITE NUMBER
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CITY
STATE
ZIP
CODE
DAY
PHONE
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EMAIL
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CARD
NUMBER
EXP.DATE
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BILL
TO (If Different)
NAME
ADDRESS
APT/FLOOR/SUITE NUMBER
CITY
STATE
ZIP
CODE
DAY
PHONE
MESSAGE
*Shipping
Charges* |
| 1
bottle |
$4.50 |
| 2 to 6 bottles |
$6.50 |
| 7 to 12 bottles |
$9.99 |
| Over 13 bottles and All Gift Bags |
Contact us for S&H. |
| Love Gloves & Wash Bags |
Free S&H |
*Shipping
charges apply to the continental US only. Alaska, Hawaii, and all other locations, please call for S&H charges.* |
|
SUBTOTAL
8.0%
Tax
(IL ONLY)
Shipping
TOTAL
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