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UreaSample.Com

Mail Order Form

 

 

 

 

Instructions:

 

Fill out the table below to look just like the checkout cart on our site, include a money order for the exact amount and mail to the address below.Please use all current prices for products and shipping. Current prices may be obtained from our website order page and shopping cart.

 

 

Send Order to:

 

848 N. Rainbow Blvd. #1192

Las Vegas NV 89107

 

 

Money Order:

 

Please make out to . You may purchase money orders at the post office and most convenience stores.

 

 

Qty

Product Number

Product (donít forget to specify gender)††††††††

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shipping Method:

2-3 Days by 5:00 p.m. $14.95
Second Day by 5:00 p.m. $19.95
Next Afternoon by 3:00 p.m. $24.95
Overnight Express by 12:00 noon $29.95
International 2nd Day (Canada Only) $44.95
International 2nd Day (Outside U.S.) $54.95

 

 

 

 

 

 

 

Total:

 

 

 

Total Enclosed:

 

 

Shipping Info. :

 

Name

Address

Address 2

City

State, ZIP

Special Instructions

Email

 

Thank you for your purchase!