To See Products and Prices, Click Here .
Click here to go back to our main page.

Essiac Tea Herbal Remedies Printable Order Form

Essiac Tea Herbal Remedies Order Form

Don’t want to order online? Simply print this essiac order form (select Print from the File Menu on your browser or press Ctrl-P on your keyboard), fill it out, and send it to the address at the right, along with your money order or personal check. (allow 5 business days for personal checks to clear) To order with a credit card, use the shopping cart on our main site, or fill in credit card info below. This form is for US orders only.
Thank You!
lisa@essiac-tea-herbal-remedies.com

Please Make Checks/Money-Orders Payable to:
Essiac Tea Herbal Remedies

Shipping Info: Under $10, add $2.00
$10.01 to $25.00, add $5.00
$25.01 to $50.00, add $7.50
$50.01 to $100.00, add $10.50
For orders over $100, or if you need help with this form, please call 1-877-8-ESSIAC.

Mail To:

Essiac Tea Herbal Remedies
PO Box 1042
Carrboro NC 27510 USA

lisa@essiac-tea-herbal-remedies.com
www.essiac-tea-herbal-remedies.com

QuantityItem Name and DescriptionPrice Each******Line Total

Sub-Total

Add Shipping Cost

Grand Total, Including Shipping


THANK YOU!
Please
visit
again
soon!


PLEASE FILL OUT SHIPPING INFORMATION COMPLETELY

Name________________________________________________
Address______________________________________________
City___________________State_____ Zip Code____________
Phone____________________________
email________________________________________________
If ordering by credit card:
Card Number__________________________________________
Exp. Date______/______ CVV code (3 digits on back of card)___
Billing address if not the same as shipping address
________________________________________________________________