Reflexology Science Institute - Order Form
Please print and fill out this order form with check or credit card
information and mail to:
Reflexology Science Institute, 1170 Old Henderson Road, Ste 206, Columbus OH 43220
| Product | Price Each | Quantity | Total |
| T- Shirt | $25.00 | ||
| Sweat Shirt | $49.00 | ||
| Small Foot Chart (3x5) | $7.00 | ||
| Medium Foot Chart (11x17) | $23.00 | ||
| Large Foot Chart (15x24) | $50.00 | ||
| The Complete Guide to Foot Reflexology book | $16.95 | ||
|
Shipping Charges (inside continental USA): $0 - $50 = $3.00 Over $50 = 8% of product total
Shipping Charges (outside continental USA): |
Product Total | ||
| Sales Tax (OH) | |||
| Handling | $4.00 | ||
| Shipping | |||
| Total | |||
Name:_____________________________________________ Phone:______________________
Address:_______________________________________________________________________
City:________________________________ State:__________ Zip:________________________
( ) Mastercard ( ) Visa ( ) Discover ( ) Amex Card
Number:_______________________________
Signature:_______________________________________ Exp. Date:_______________________
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