Fill out this order/payment form, print and FAX or mail the signed original copy with your payment in U.S dollars to:
FAX: (800) 839-7684
3112 Van Buren Dr.
Tampa, FL 33611
US: +01 (813) 419-3547
*Name or Company
Address Line 2
(fill in only the applicable fields, ie: PayPal & Money Orders skip credit card portion)
Name on card
Credit Card Number
Billing Zip Code
PayPal Send payment to:
Money order / check #
C.O.D. This option is only available to U.S destinations and only if Advantig is shipping products.
*DESCRIPTION OF ITEM OR SERVICE
Florida Residents add 7% sales tax)
S&H are United States destinations per package. Overseas add $5.00 (Priority shipping not available).
Priority (U.S. only)
Shipping & Handling
Multiple items are usually shipped in a single package.
Take 10% off if you buy within 15 days of your original trial.
* Required Field