Site hosted by Angelfire.com: Build your free website today!

Jasmine Hair Order Form

My Favorite Web sites

Jasmine Hair Sheen and Conditioner
Jasmine Hair Products(Intro Page)
Jasmine Hair Products (Page 1)
Jasmine Hair Products (Page 2)

Item Item
Item Description Length Unit Price Quantity Extension Price
           
           
           
           
           
           
           
           
           
           
        Total = $

Print this page to order:

Hair Goods are not returnable and no C.O.D

Send to: Name:_____________________________________________

Address:___________________________________________

City:______________________________________________

State:___________________ Zip Code:_______________________

Phone Number:______________________ Email:________________________

VISA #:_____________________________________ Expiration Date:_____________

Mastercard #:__________________________________Expiration Date:_____________

Debit Card (VISA and MC) #:_______________________________Valid Thru:_______

Money Order Enclosed for (amount): $_______________________

International Healthcare Supply Corporation

3165 Venard Road, Downers Grove, IL 60515 USA

Email:tersylas@aol.com

Toll Free : 1-800-909-8775 Access Code 01

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



Email: tersylas@aol.com