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Order Form   

 

Please fill in the order information below, and let us know how to contact you.

Select the type of card you will be using:

* Credit Card Number

 "Do not include spaces or dashes"

* Expiration Date 

   ie. mm/dd/yyyy
     
Package 1 (Nite-Walker Dog leash Flashlight attachment) QTY.  @ $19.90 ea. Includes S & H
   
Package 2 (Cellulose-Skin tone 6 Small) QTY.  @ $8.45 ea.  
   
Package 3 (Cellulose-Clear 6 Large) QTY.   @ $7.95 ea.  
   
Package 4 (Cellulose-Skin tone 6 Large) QTY.   @ $8.45 ea.  
   
Package 5 (Cellulose/Carbon-Clear 6 X-Small) QTY.   @ $8.95 ea.  
   
Package 6 (Cellulose/Carbon-Skin tone 6 X-Small) QTY.   @ $9.45 ea.  
   
Package 7 (Cellulose/Carbon-Clear 6 Small) QTY.   @ $8.95 ea.  
   
Package 8 (Cellulose/Carbon-Skin tone 6 Small) QTY.   @ $9.45 ea.  
     
Package 9 (Cellulose/Carbon-Clear 6 Large) QTY.  @ $8.95 ea.    
   
Package 10 (Cellulose/Carbon-Skin tone 6 Large) QTY.  @ $9.45 ea.  
   
Package 11 (Carbon/Copper-Skin tone 6 X-Small) QTY.  @ $9.95 ea.  
   
Package 12 (Carbon/Copper-Skin tone 6 Small) QTY.  @ $9.95 ea.  
   
Package 13 (Carbon/Copper-Skin tone 6 Large) QTY.  @ $9.95 ea.  
   
Package 14 (Currently Not Available) QTY.  @ $4.95 ea.  
   
Package 17 (Nasal Dilators-1XS, 2Small, & 1Large) QTY.   @ $4.95 ea.  
   
Package 18 (Sizing Package XS, Sm, Lg) QTY.   @ $2.50 ea.  
     

* Name
Title
Company
* Address
* E-mail
* Phone (i.e. 321-453-3848)

Please have a salesperson contact me

* Designates a required entry

Note: If you do not receive an e-mail confirming your order within 48 hours of your submission, please resubmit your order. Please allow 4 to 7 days for delivery.

 

We are currently seeking Distributors World Wide.

If interested please contact us or let us know by going to our Feedback page.

 

                   

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Last modified: March 15, 2009