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| Chin-Up StripsŪ - Retail - Volume Discount Prices - 03/15/08 |
The Chin-Up Company |
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| To Order Online: CLICK "Order Online" above | DATE:_____________________ |
| NAME: | _______________________________________________________________________ | ||||
| ADDRESS: | _______________________________________________________________________ | ||||
| CITY: | __________________________________ | STATE: | _______ | ZIP: | _______________ |
| EMAIL: | _____________________________________ | PHONE#: | ____________________ | ||
| SEND BROCHURES? ___YES HOW MANY _______ | P.O.#: | ____________________ | |||
| U. S. Priority Mail cost includes tracking. The cost is the same for one pack or 10 packs! | |||||
| Chin-Up Strip Type: | Quantity: | Price | Pri. Mail | Subtotal |
|
___ WHITE
Horseshoe (#11130) |
_____ 30ct. Packs | $13.99 | $4.99 | $__________ |
|
___ TAN
Horseshoe (#22230) |
_____ 30ct. Packs | $13.99 | $4.99 | $__________ |
|
___ TAN
Boomerang (#33330) |
_____ 30ct. Packs | $13.99 | $4.99 | $__________ |
|
Shipped UPS Grd ___ 1 - 500ct. Tan Horseshoe Roll |
$145.00 |
$10.50 |
$__________ |
|
| Shipped UPS Grd ___ 1 - 500ct. Tan Boomerang Roll | $145.00 | $10.50 | $__________ | |
| Breathe Right Nasal Strips Type: |
Quantity: |
Price | Shipping | Subtotal |
| ___ Large Tan Strips | _____ 38ct. Packs | $15.00 | Free | $__________ |
| ___ SM/Med Clear Strips | _____ 38ct. Packs | $15.00 | Free | $__________ |
| ReliaMed | Quantity: | Price | Shipping | Subtotal |
| ___ Adhesive Remover Wipes | _____ 50ct. Packs | $12.99 | Free | $__________ |
| ___ Skin Protective Barrier Wipes | _____ 50ct. Packs | $12.99 | Free | $__________ |
| * * * Shipping Outside US - Add $15.00 to each order | $__________ | |||
| 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:____________________________________________________________________ |