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Consumer Product Order Form |
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Customer/Store Name: _____________________________
Phone: ( ) ________________
Address: _________________________________________
City: ____________________________________________
State: _______ Zip: _______
SHIP-TO Address (if different from address above)
Customer/Store Name: _____________________________
Phone: ( ) ________________
Address: _________________________________________
City: ____________________________________________
State: _______ Zip: _______
LIFESTYLE SOLUTIONS FOR BEAUTY (available in 30 or 60 cap bottles)
1. LUMINOUS Pearl Extract Skin Formula™ _______ 30 Cap $17.99
_______ 60 Cap $29.99
LIFESTYLE SOLUTIONS FOR WOMEN (available in 60 cap bottles)
2. PMS SOLUTION Pre-Menstrual Formula™ _______ 60 Cap $15.99
3. MONTHLY SOLUTION Menstrual Restorative Formula™ _______ 60 Cap $15.99
4. MENOPAUSE SOLUTION Change of Life Formula™ _______ 60 Cap $15.99
5. AGELESS SOLUTION Hormonal Balancing Formula™ _______ 60 Cap $19.99
6. BREAST SOLUTION Healthy Breast Formula™ _______ 60 Cap $15.99
LIFESTYLE SOLUTIONS FOR WOMEN (available in 60 cap bottles)
7. INTEGRITY Atheletic Performance Formula™ _______ 60 Cap $25.99
8. SUSTAIN Super Adaptogen Formula™ _______ 60 Cap $25.99
QTY ITEM# PRICE DISC % DISC $ EXT PRICE
____ _____ @ $______ ______ _____ $_________
____ _____ @ $______ ______ _____ $_________
____ _____ @ $______ ______ _____ $_________
Order Sub-Total $__________
Sales Tax (8.25 in CA) $__________
Shipping/Handling (see chart) $__________
ORDER TOTAL $__________
Shipping/Handling Chart
(for Continental USA*)
Order Qty Add
1-2 Bottles $5.00
3-4 Bottles $5.00
5-6 Bottles $6.00
7 + Bottles FREE
*Alaska, Hawaii and Puerto Rico
add an additional $5.00
Far East Summit normally ships via UPS Ground within 3 working days of order.
Orders shipped to a PO Box will ship via USPS. Add $5.00 for COD orders.