Optimoil
Order Form
Simply Print and Mail OR Fax
Toll Free Fax: 1-888-777-0038
Must be 18 years or older to purchase
Make Checks Payable to: Red Door Marketing Ltd.
Please fill
out the following form. Check the box next to the product
you wish to order, and then mark the quantity you wish to order.
|
Product
|
Quantity
|
Price
|
Amount
|
||
|
|
$ 59.95
|
$ | |||
|
|
$109.95
|
$ | |||
|
|
$159.95
|
$ | |||
| |
|||||
|
All prices are in US Funds.
|
Sub-Total
|
$ | |||
|
+
Shipping
|
$ | ||||
|
+
Tax
|
$ | ||||
|
Total
Order
|
$ | ||||
|
Thank
you for your Order. Additional
Information and/or |
Credit Card Number
(no spaces) Expiry Date________________________________ CVV2#____________________________________ Card Type_________________________________
Make
checks payable to:
Name:_____________________________________ Address:___________________________________ __________________________________________ __________________________________________ Phone:____________________________________ E-Mail:____________________________________ |