Order Form

We accept VISA MASTER CARD AMERICAN EXPRESS AND DISCOVER

ORDER FORM YOUR ORDER WILL BE PROCESSED ON THE SAME BUSINESS DAY * IF ORDER IS PLACED BY 1PM est.*
	Body Massager $259.95	Qty

	Foot Massager $279.95	Qty

	COMPLETE Set Special $449.95 Best Deal save $89.95!!	Qty

Billing Information
Full Name **
Company Name
Address 1
Address 2
City
State
Zip Code
Phone Number **
E-mail Address **

If Shipping and Billing information are the same , check here.

Shipping Information
Full Name **
Company Name
Address 1
Address 2
City
State
Zip Code
Phone Number **
E-mail Address **

Credit Card Information
Credit Card
Credit Card Number
Exp. Date
CID Number	VISA/MC DISC CID are the last 3 numbers on the signature strip
	American Express CID are the 4 numbers on the front right of card

UPS Shipping Options
Voltage **
UPS
Comments

Shipping rates apply to the Continental United States only, Call for others.

State tax will be added for all applicable States

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