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| Chin-Up StripsŪ - price and shipping- 01/23/2012 |
Dale Miller, Inc. |
|
| Call 1-888- 835-4563 or Print & Fax order to 678-298-9988 | DATE:_________________ |
| NAME: | _______________________________________________________________________ | ||||
| ADDRESS: | _______________________________________________________________________ | ||||
| CITY: | __________________________________ | STATE: | _______ | ZIP: | _______________ |
| EMAIL: | _____________________________________ | PHONE#: | ____________________ | ||
| SEND BROCHURES? ___YES HOW MANY _______ | P.O.#: | ____________________ | |||
| FREE Priority Mail in US on orders of SIX to TEN 30 ct packs at price listed below. | |||||
| Chin-Up Strip 30ct & 500ct - Type: | Quantity: | Price | US-S/H | Subtotal |
|
___ WHITE
Horseshoe (#11130) |
_____ 30ct. Packs | $14.99 | 1.30 a pk | $__________ |
|
___ TAN
Horseshoe (#22230) |
_____ 30ct. Packs | $14.99 | 1.30 a pk | $__________ |
|
___ TAN
Boomerang (#33330) |
_____ 30ct. Packs | $14.99 | 1.30 a pk | $__________ |
| ___ 500 ct. Tan Horseshoe Roll (Shipped UPS Ground) | $159.99 | $9.99 | $__________ | |
| ___ 500 ct. Tan Boomerang Roll (Shipped UPS Ground) | $159.99 | $9.99 | $__________ | |
| ___ 510 ct. White Horseshoe Bulk Pack (Shipped UPS Ground) | $169.99 | $9.99 | $__________ | |
| Wholesale 60/30ct pack case - Type: |
Quantity: |
Price | US-S/H | Subtotal |
| ___ WHITE Horseshoe (#11130) | _____ 60/30ct. Packs | $588.00 | $9.99 | $__________ |
___ Tan Horseshoe (#22230) ____Tan Boomerang (#33330) |
_____ 60/30ct. Packs
_____ 60/30ct. Packs |
$588.00 $588.00 |
$9.99
$9.99 |
$__________ $__________ |
| ReliaMed | Quantity: | Price | US-S/H | Subtotal |
| ___ Adhesive Remover Wipes | _____ 50ct. Packs | $14.99 | 1.30 a pk | $__________ |
| ___ Skin Protective Barrier Wipes | _____ 50ct. Packs | $14.99 | 1.30 a pk | $__________ |
| * * * 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 | $__________ | |||
| Credit Card #_____________________________________________________________________ |
| Card Type: ____ Visa ____ MasterCard ____ AmEx ____ Discover Exp. Date: _____________ |
| Name on Card:____________________________________________________________________ |