We accept Visa, MasterCard, Check, Money orders.
Order
Form
E. Mail:______________________
To get more information on each product click on the underlined name of the product.
|
Product
|
Price
|
Number
|
Total
|
|
|
1
|
$25/$50
|
_________
|
_________
|
|
|
2
|
$20/$40
|
_________
|
_________
|
|
|
3
|
$20/$40
|
_________
|
_________
|
|
|
4
|
$20/$40
|
_________
|
_________
|
|
|
5
|
$25/$50
|
_________
|
_________
|
|
|
6
|
$20/$40
|
_________
|
_________
|
|
|
7
|
$20/$40
|
_________
|
_________
|
|
|
8
|
$20/$40
|
_________
|
_________
|
|
|
9
|
$25/$50
|
_________
|
_________
|
|
|
10
|
$30
|
_________
|
_________
|
|
|
11
|
$30/$60
|
_________
|
_________
|
|
|
12
|
$30/$60
|
_________
|
_________
|
|
|
13
|
$25/$50
|
_________
|
_________
|
|
|
14
|
$25/$50
|
_________
|
_________
|
|
|
15
|
$30/$60
|
_________
|
_________
|
|
|
16
|
$30/$60
|
_________
|
_________
|
|
|
17
|
$6/pair
|
|||
|
18
|
$30/$60
|
|||
|
19
|
$30/$60
|
|||
|
20
|
$25/$50
|
_________
|
_________
|
|
|
21
|
sesame
|
$30/$60
|
_________
|
_________
|
|
22
|
Lecture on the colloidal Solutions
by Dr. Talmor
|
$10
|
DVD/VHS
|
_________
|
|
23
|
Lectures on Biosyntonie
by Dr. Talmor
|
$30
|
3 DVD/VHS
|
_________
|
|
Sub Total::
|
_________
|
|||
|
Discount if applies
|
_________
|
|||
|
Please call for shipping charges
|
Shipping::
|
_________
|
||
|
|
Total:
|
_________
|
| Card Number:________________________________________ | Total Charged_______________ |
| Expiration Date:__________ Security Number:__________ | Visa___ Master Card___ Discover_______ |
|
Billing Address________________________________________ City_________________________________ Zip:________________ |
Payment Mode: Credit card (Visa/MC only)____ Check__ M.O.____ |
| Name on the card:___________________________________ |
please call us for more information. |
| Signature:_________________________________________ |