Formula 40 Stretch Mark Treatment™
For faster delivery you may order online using your credit card or print this form and fax it to (607) 936-8307. To place an order via "snail mail" print this order form, fill it out, and mail it with your check, money order or credit card information to:

SELECT PRODUCTS
Dept. FS-4
P. O. Box 667
Elmira, NY 14902
United States of America

NOTE: IF YOU DON'T HAVE A PRINTER, AND WISH TO MAIL US YOUR ORDER, SIMPLY WRITE THE INFORMATION ON A PIECE OF PAPER.

Click Here To >>>ORDER ONLINE NOW !!!

You may also order with your credit card via our toll free order line at (800) 546-3962.   For inquiries call (607) 936-4617.



 

Sizes Quantity Cost Ea. Total
(One 3 ounce Jar)      Small $19.95
(One 6 ounce Jar)      Medium $29.95
(2 Jars = 12 ounces)     Large $45.95
(4 Jars = 24ounces)   X-Large $75.00
                         Prices include postage inside the continental United States. All others add $9.00 US Shipping/Handling.
 
Name: ______________________________________
Address: ______________________________________
City: _______________State:____________Zip:__________ 
Country: ______________________________________
 Email Address:   __________________________________
 Phone No.:  ______________________________________

For credit card orders:
Type:______________________
No._________________________________
Exp. Date:__________________

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