MAIL ORDER FORM

Simply Print & Mail Payment To:
FB Marketing
PO Box 2383
Jamestown, NC 27282
  
Make certified checks and money orders payable to  FB MARKETING. All shipments are packaged DISCREETLY. Credit card orders will appear on your statement as FB MARKETING. NOTE: Personal checks are accepted, however, shipment will only be made after the check clears. This process usually takes 7-10 days...

 

CARD HOLDER INFORMATION
Name
Street Address
City
Country
State
Zip/Country Code
Email Address
Phone Number
Fax Number
     
DELIVERY INFORMATION

(Leave blank if same as CARD HOLDER ADDRESS)

 

ITEM CODE

DESCRIPTION

PRICE US$

QUANTITY (Specify)

001

1 bottle, 1 month supply

$   39.95

 

002

2 bottle, 1 month supply

$   69.95

 

003

3 bottle, 1 month supply

$   99.95

 

004

4 bottle, 1 month supply

$ 119.95

 

005

Each Additional bottle after 4

$25./each

 

 

SHIPPING INFORMATION
 
SHIPPING IS FREE!
   
CREDIT CARD INFORMATION
Please circle the credit card type being used
MASTERCARD       AMEX        VISA
    
CARD NUMBER
EXPIRATION DATE
*SECURITY CODE
*This is the three or four-digit security code that is printed on credit cards. The value appears in reverse italic at the top of the signature panel on the back of the credit card, or just above the end of the credit card number on the front of the card.

 

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