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DermabrasionCrystals.com 800-899-7141
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MSDS
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ORDER FORM PLEASE PRINT AND FAX TO US Fax order to 631-582-2820 or Call 516-592-3488
Shipping address: ____________________________________ Residence or Business ______________________________________ ______________________________________ Phone Number _____________________________________ Credit Card # _______________________________________ Type: V MC Discover Amex Cardholder Name: _______________________________________ Expires________________ Security code*______________ Billing address _______________________________________ _______________________________________
Cardholders Signature _______________________________________ Email Address_________________________________ We will send your tracking number SIZES----90, 100, 120, 180 11-07-08 Please ship the following: Size Item # Nbr each X Price each = Total Cost
1. _____ ______ _________ _________ $_________ 2. _____ ______ _________ _________ $_________ 3. _____ ______ _________ _________ $_________ TOTAL $ __________ |
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