RPM TOTAL VITALITY

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18032 Lemon Drive, Suite C, Yorba Linda, CA 92886-3386
(714) 524-8864 Fax (714) 524-3247
Order Toll Free, 24 Hours a Day:  (800) 234-3092
 

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Please print clearly

ORDER FORM

 
NAME

ADDRESS

CITY STATE ZIP



COUNTRY PHONE FAX



EMAIL

QTY. ITEM CODE DESCRIPTION TOTAL
       
       
       
       
       
       

Thank You For Your Order

SUB TOTAL

[CALIFORNIA RESIDENTS ADD 7.75%]   SALES TAX

BASIC SHIPPING CHARGE [All Orders]

CANADIAN ORDERS  via

Best Method add

$5.00 + $1.00 ea add'l lb.

INTERNATIONAL ORDERS  via

 Best Method add

$10.00 + $1.00 ea add'l lb.


ALTERNATIVE SHIPPING OPTIONS  (CIRCLE ONE)

** USPS Express MailŪ Available Worldwide **

UPS [Domestic Only]

 USPS - Express MailŪ  

add $20.00 1st lb.

$2.00 ea add'l lb.

 USPS - Global Express MailŪ

add $25.00 1st lb.

$2.00 ea add'l lb.

UPS - 2ND DAY AIR

add $12.00 1st lb.

$2.00 ea add'l lb.

UPS - 3 DAY SELECT

add $10.00 1st lb.

$1.00 ea add'l lb.

Approximately 5 Bottles per pound             All amounts are U.S. $

GRAND TOTAL

$7.00
 
 

Order online at: WWW.RPMTV.COM or WWW.RPMTOTALVITALITY.COM

 

CHECK     MONEY ORDER    (circle payment option)

CREDIT CARD / CHECK NUMBER __________________________________  EXP. DATE _____ / _____

SIGNATURE ______________________________________________________________________