|
ORDER FORM
|
Please Print
|
|
|
PENDULUMS
|
||
| COST: $20. /ea. in
____Bubinga or Shipping and Handling: $3./each |
 |
Please Print and Mail Order Form to:
Infinite Branches 515 W. Bethel Road Bethel, ME 04217 603-466-2265 info@infinitebranches.com |
| Name of Purchaser | |
| Name of Recipient | |
| Shipping to Recipient rather than Purchaser? ____Yes ___No | |
| Shipping Address | |
| Telephone # of Purchaser | |
| Email Address of Purchaser | |
| Specific Wellness Energy: | |
| or energy the recipient most needs at the time? ___Yes | |
| Check Amount Enclosed: | |
| Amount to charge to card: | |
| Visa____or Mastercard___ | |
|
Card Number
|
|
|
V Code
|
|
| Signature of cardholder: | |
| Note: Maine residents must add 5% sales tax |