NAME:

E-MAIL:

ADDRESS:

CITY:  STATE: ZIP CODE:

PHONE:

TYPE OF CREDIT CARD:

CREDIT CARD #:   EXP. DATE:-

Shipping & Handling:   

Order Total            Shipping Amount

$5 - $24.99             $7.00

$25 - $60                $12.00

$61 - $90                $18.00

  PLEASE LET  US KNOW THE FOLLOWING INFO: 1. Product Name 2. Your Choice of Scent 3. How Many Would You Like

      NOTE: WE WILL E-MAIL YOU BACK WITH YOUR TOTAL PLUS SHIPPING AND HANDLING FOR YOUR APPROVAL BEFORE WE CHARGE YOUR CREDIT CARD 

THANK YOU!