Great Taste No Pain - Phone, Fax and Mail Form

To Phone Your Order...

To Fax or Mail Your Order...

Call us at 1-315-295-1236 Ext. 1

Office hours are Monday-Friday
8:30AM-4:30PM US Eastern Time

No need to fill out or print the Order
Form if you are ordering by phone.

**Print This Form After You Fill It Out
1)	Fill out the form below. You will NOT be submitting this form over the internet. To Fax your order, fax to 1-315-468-5818 24 hrs/day. To Mail your order, use the address below.

2	Once you've chosen product, shipping and tax options: Print and either fax or mail this page.

Product

Price

Quantity

Amount

Great Taste No Pain - Save $10.00 today

$39.97

Billing Address: *required | Shipping Address is the same as the Billing Address

*Name:
*Address:
*City:
*State:
*Country:
Non US Province/State:
*Zip/Postal Code:
*Phone:
*E-Mail:

Shipping Address: *required

*Name:
*Address:
*City:
*State:
*Country:
Non US Province/State:
*Zip/Postal Code:
*Phone:
*E-Mail:

Credit Card Orders: *required

*Card Type:
*Name on Card:
*Credit Card#:
*CVV2#:	Security Code (3 or 4 digits)
*Expires:	/ (xx / xxxx)
*Signature:
	__________________________________________________

For Checks/Money Orders: (fill out only shipping address above)

Make check payable to:

Holistic Blends, Inc
Only Money Orders or Bank Checks accepted in USD.
Mail check with this form to the following address:
Holistic Blends, Inc.
PO Box 359
Syracuse, NY 13209-0359

Tax:

New York State Residents - 8.25% sales tax added before shipping

Shipping:

	UPS Ground (U.S. orders) = $6.95 USD (2-5 Bus. days)
	UPS 2-Day Select (U.S. orders) = $12.95 USD (2 Bus days)
	UPS 3-Day Select (U.S. orders) = $9.95 USD (2-3 Bus days)
	U.S. Express Mail 1-2 days (U.S. orders) = $17.85 USD
	UPS Next Day (by 5pm) (U.S. orders) = $25.35 USD
	Intl First Class Mail (Outside U.S.) = $13.50 USD (9-18 Bus days)
	International Priority Mail (Outside U.S.) = $19.00 USD (6-9 Bus days)

$	+	$	+	$	=	$
Order Amount		8.25% (NY Residents only) Order Amt x .0825		Shipping		Total Investment

Click here to print this form

All orders received by 8:00 AM (M-F) U.S. Eastern Standard Time ship the same day