Mail Order

 

femestril fax order page

Mail Order Page


Please print this form, fill out all applicable information, and mail to: Pro Edge Labs Inc.
5018 Lochside Drive
Victoria BC V8Y 2E7
Canada

Note:

There are 2 pages to this order form

 

SHIPPING INFORMATION
*** Please choose international shipping if you are outside the USA ***

Contact Person: ________________________________
Phone Number:________________________________
Email Address: ________________________________
Delivery/Mail Address: ________________________________ ___________________________________________


PAYMENT DETAILS

 

Please make all bank drafts and money orders payable to: “Pro Edge Labs Inc.Notice: All payments must be made in USD (US $) only. We accept the following forms of payment (U.S. funds only):

  • credit/debit card
  • cashier’s check or bank draft
  • money orders

Note: We do not accept personal checks or COD’s.

NEXT – CONTINUE TO NEXT PAGE

If paying by credit card – Please select the credit card type used for this order:
MasterCard
Visa
American Express

 

If you are paying by credit card, please fill in the required information below:

Card Number: ______________________ ___________________
Card Expiration Date (MM/YY):

__ /__ CVV2 Number: ______ What is the CVV2 number?

Name as it appears on card: __________________________________
Credit Card Street Address: __________________________________
Credit Card City, State: __________________________________
Credit Card Country: __________________________________
Credit Card Zip/Country Code: __________________________________
Cardholder Signature: ________________________________________


*** NOTE *** We never automatically ship more boxes to you and bill your credit card unless you reorder.


*** Please choose international shipping if you are outside the USA. ***

Please select your shipping cost option below: NOTE – FREE SHIPPING ON ORDERS OF 4 OR MORE BOXES

FedEx
Ground 3-5 Days – $12.95 (USA) *Full tracking
FedEx
Express 2-3 Days – $17.95 (USA) *Full tracking

USPS Global Priority Mail (INT) 5-7 Days –
$28.95 (No Tracking)

FedEx International Priority (INT) 3-5 Days –
$30.95 (Full Tracking)

 

QUANTITIES

 

Item Code Description Price in US$ Quantity (Please Specify)
001 1 box $49.95 ______
002 2 boxes $84.95 ______
003 3 boxes $119.95 ______
004 4 boxes $154.95 ______
005 5 boxes $189.95 ______
006 6 boxes $224.95 ______
009 9 boxes $298.95 ______

 

Please print this form, complete all required information and mail to:

Pro Edge Labs Inc.
5018 Lochside Dr
Victoria BC V8Y 2E7
Canada