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Chin-Up StripsŪ - Volume discount prices & shipping- 01/01/2013

Dale Miller, Inc.
Chin-Up Strip Company
1820 Ridgemill Terrace
Dacula, GA 30019
www.chinupstrip.com
 

1-888-835-4563
In Atlanta: 678-482-8508
Fax: 678-298-9988

dmiller176@aol.com

Call 1-888-835-4563 or print & fax order 1-678-298-9988       DATE:_______________
 NAME: _______________________________________________________________________
 ADDRESS: _______________________________________________________________________
 CITY: __________________________________ STATE: _______ ZIP: ______________
 EMAIL: _____________________________________ PHONE#: ___________________
 SEND BROCHURES?   ___YES      HOW MANY _______ P.O.#: ___________________
 
30 ct. pks - 300 ct pks - 500 ct rolls Quantity: Price US-S/H Subtotal
  ___ WHITE Horseshoe (#11130)
      _____ 30ct. Packs $14.99 $3.00 $__________
  ___ TAN Horseshoe (#22230)
      _____ 30ct. Packs $14.99 $3.00 $__________
  ___ TAN Boomerang (#33330)
      _____ 30ct. Packs $14.99 $3.00 $__________
  ___ Tan Horseshoe Roll (#22500) 500 strips - Ship UPS Ground $169.99 $9.99 $__________
  ___ Tan Boomerang Roll (#33500) 500 strips - Ship UPS Ground $169.99 $9.99 $__________
        
 

Quantity:

Price US-S/H Subtotal
 ___ White Horseshoe (#11130)  _____ 300 strips 10 pks  $139.90 $3.00 $__________

 ___ Tan Horseshoe  (#22230)

 ___ Tan Boomerang (#33330)

 _____ 300 strips 10 pks

 _____ 300 strips 10 pks

 $139.90
  $139.90
 $3.00
  $3.00
$__________
$__________
ReliaMed Quantity: Price US-S/H Subtotal
 ___ Adhesive Remover Wipes       _____ 50ct. Packs $13.00 $3.00 $__________
 ___ Skin Protective Barrier Wipes       _____ 50ct. Packs $13.00 $3.00 $__________
* * * Email: dmiller176@aol.com for shipping cost outside US 48 states    $__________
GA Residents Only - Sales Tax @ 6.0%    $__________
Send Check or use Credit Card - TOTAL    $__________
* * * Approved credit account companies agree to pay their PO within 30 days from date of delivery.
Credit Card #_____________________________________________________________________
Card Type:   ____ Visa   ____ MasterCard   ____ AmEx    ____ Discover     Exp. Date: _____________
Name on Card:____________________________________________________________________