Folligro Mail/Fax Order Form
If you
would
prefer to purchase your Arcon Folligro at our discounted internet Prices by
mail Order. Please print and complete the order form below and either fax or
post it to.
Folligro
Ltd. , Jyllandsgade 33, DK-6700
Esbjerg, faxnr.: + 45 75 13 15 90
|
Product |
Quantity |
Unit price
|
Line Total |
|
1 month supply of Folligro |
1 box x 30
capsules Folligro system 1 1
spraybottle x 60 ml. Folligro system 2 |
$ 49,90 |
$ |
|
3 month supply of Folligro |
3 box x 30
capsules Folligro system 1 3
spraybottle x 60 ml. Folligro system 2 |
$ 139,90 |
$ |
|
6 month supply of Folligro |
6 box x 30
capsules Folligro system 1 6
spraybottle x 60 ml. Folligro system 2 Money back
guarantee |
$ 249,90 |
$ |
|
12 month supply of Folligro |
12 box x
30 capsules Folligro system 1 12
spraybottle x 60 ml. Folligro system 2 Money back
guarantee |
$ 479,90 |
$ |
|
Post and Packaging World Wide Recorded Air
Mail |
1 |
$ 15,00 |
$ |
Payment Details:
By: Cheque., P0 or Money Order
(Crossed and Made Payable to ARCON UK Ltd)
By: Credit/Debit Card. (Please indicate which Card) Sorry
but
we can not accept American Express
|
MasterCard |
Visa |
Switch |
Delta |
Other (Please Specify) |
Card Number ٱٱٱٱ
ٱٱٱٱ ٱٱٱٱ
ٱٱٱٱ ٱٱٱٱ
Expiry Date____________ I_________ Switch Issue
No_____________ Valid From______ I__
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Signature
of Card
Holder |
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Name on the Card |
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Card Address |
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Post/Zip Code |
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Fax/Tel # |
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e-mail
for acknowledgement order |
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