See-clear.org - Herbal Relief For
Eye Problems
Michele Morrow or See-clear.org (check payable
to)
Voice#: 1- 360-326-8997/Fax: 1-360-635-5224
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Fill in your order and fax (number above) or mail to address above.
Name:________________________________________________________________________ Address:______________________________________________Apt.#_______________________ City:_______________________________State/Country:____________________Zip:__________ Phone:___________________________ E-Mail Address: ___________________________ Visa/MasterCard/Discover/Amex Number(Circle One) :________________________________ Card Expiration Date:_______________ Security Code on card back: _______ Signature (required on credit card orders):_____________________________________________ Eyewash: 3-mo.-$35 (sku-ew/3mo) 4-mo.-$45 (sku-ew/4mo) 6-mo.-$65 (sku-ew/6mo)Eyecup: $3/ea. (sku-ec/ezy-care) Eyecup required to use this product-Glass.Eye Dropper: $1/ea. (sku-ed/st [straight] or sku-ed/bt [bent]) - Alternate w/eyecup use.Container: $2.50/ea. (sku-abr/4oz.) 4 oz. Amber Boston Round - (Glass)Ear Candles: $4.00/pair (sku-bec) – These are in pairs. Beeswax & unbleached cotton
Item # |Quantity| Description | Item Total | 1. sku-__________|________|_________________________________________|_____________| 2. sku-__________|________|_________________________________________|_____________| 3. sku-__________|________|_________________________________________|_____________| 4. sku-__________|________|_________________________________________|_____________| 5. sku-__________|________|_________________________________________|_____________| Sub total |_____________| U.S. Shipping/Handling: | International Shipping/Handling
$0 - $49.99 |
$8.00 |
$0 – 49.99 |
$10.50 |
$50 - up |
$10.00 |
$50 – up |
$14.50 |
TOTAL/w shipping AMOUNT ENCLOSED |_____________|