Fax Order Form : Bee Pollen Capsules, Bee Pollen Capsules, Bee Pollen Capsules

NATURALLY NEW ZEALAND FACSIMILE ORDER FORM

FAX NUMBER: 064 3 341 8266

To complete your order, please provide us with your personal information.
- Then print out this form and fax to the above number.
Note: Only add one Shipping cost per total order.
- Min order is 3 - 60x500mg capsules bottles ( 3 months application )

Product Information

Quantity :

BeeFit Bee Pollen
60 capsule bottles

Shipping: US$9.00

Billing Information

Total Amount:

US$

Credit Card:

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Card Number:

Expiry Date:

E-Mail Address:

Shipping Information

Name:

Shipping Address:

City:

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Additional Comments (Additional Shipping Information, Unlisted Options, etc.)

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