American Pharma Inc. Order Form
Simply Print and Mail OR Fax
Toll Free Fax: 1-888-777-0038
Must be 18 years or older to purchase
Make Checks Payable to: Red Door Marketing Ltd.
Please fill out the following form. Check the box next to the product
you wish to order, and then mark the quantity you wish to order.
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Product
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Quantity
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Price
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Amount
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Zynextra3-90 1 Month Supply |
$ 49.95
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$ | |||
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Zynextra3-180 2 Month Supply |
$ 89.95
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$ | |||
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Zynextra3-270 3Month Supply |
$ 129.95
|
$ | |||
|
Preferred Membership* see below |
N/A
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$ 455.88
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$ | ||
 |
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All prices are in US Funds.
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Sub-Total
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$ | |||
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+ Shipping
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$ | ||||
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+ Tax
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$ | ||||
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Total Order
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$ | ||||
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*Preferred Membership Details American Pharma Inc. has a very special ‘Preferred Membership Program’. The Preferred Membership Program offers convenience and savings to our valued customers. Over 90% of our thousands of satisfied customers have chosen to enroll! How it works: Preferred price per 90 capsule bottle $ 37.99 (Plus shipping and handling). Based on 12 months. Your account will automatically be billed by our system and your product shipped the first day of every month. **This is a $ 50.00 savings each month based on pharmacies suggested retail price. ** Thank you for your Order. Additional Information and/or |
Credit Card Number (no spaces) Expiry Date_________________________________ CVV2#_____________________________________ Card Type__________________________________
Make checks payable to:
Name:_____________________________________ Address:___________________________________ __________________________________________ __________________________________________ Phone:____________________________________ E-Mail:____________________________________
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