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7 Day Smoke Away. MAIL ORDER FORM

Please Print this form, fill it out and mail it to the address below (if you do not have a printer, please write out the form by hand)

Please locate the price of the product(s) you are purchasing from the website

Customer Name & Address Product's Ordered

 Quantity/Price

Shipping Prices

     

 

 

 





Add
$5.95 per order for Priority Mail Shipping
 or
$8.95 for Super-Fast RUSH Delivery

 

Mail Orders: Please send this form with your USA Cash or USA Money Order or Check (personal checks held until cleared before shipment) to:

 

7 Day Smoke Away, Box 111,

325 East Jimmie Leeds Rd, Suite # 7, Galloway, NJ, 08205, USA