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For fax or mail order, print this page and complete |
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Make checks payable to: KMA Allied |
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KMA Allied |
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Babson Park, Florida 33827 |
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Toll Free: 800-625-9994
www.monrayantiperspirant.com |
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Fax: 863-638-1870 |
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FAXING CREDIT CARD FORM GO TO A SECURE LOCATION FOR YOUR
PROTECTION |
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QTY |
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Product Discription |
Size |
Price |
Amount |
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Mon Ray® Antiperspirant for Men |
1.5 oz. |
$13.25 |
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Mon Ray® Antiperspirant for Women |
1.5 oz. |
$13.25 |
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Mon Ray® Antiperspirant for Men 3 Pack |
1.5 oz. |
$29.82 |
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Mon Ray® Antiperspirant for Women 3 Pack |
1.5 oz. |
$29.82 |
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Mon Ray® 222 Athlete's Foot Treatment |
3 oz. |
$12.50 |
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Mon Ray® Oralvastin Canker Sore Treatment |
.5 oz. |
$8.71 |
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Mon Ray® Vermistat Ringworm Treatment |
1.oz |
$11.00 |
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Mon Ray® Unguistat
Nail Treatment |
1 oz. |
$32.25 |
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SUBTOTAL (includes sales tax) |
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SHIPPING AND HANDLING: |
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See Page 2 for shipping information |
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ORDER TOTAL
(Make check or money order for this amount) |
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Credit Card Type: (i.e. Visa) |
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Credit Card Number |
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Exp: |
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Shipping Information |
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Name: |
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Address: |
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