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MAIL Order Form
for Canadian Customers

Print out this form using the print option under the file menu of your browser (top left corner of your browser window), then fill in the information needed to place your order. If you have any questions about this form, give us a call at 1-817-607-8531. Mail the completed form to us at the following address:

NATURE DOC
P.O. Box 777
Joshua, TX 76058-0777
USA

ORDERING INFORMATION:

Quantity
bottles of SEACURE®, 180 capsules per bottle, 500 mg each.
boxes of SEACURE®, 180 capsules per box, 500 mg each.
bottles of SEAVIVE®, 90 capsules per bottle, 500 mg each.
boxes of INTESTIVE®, 120 capsules per box, 500 mg each.
containers of SEACURE® for pets, 100 grams with scoop.
containers of SEACURE® for pets, 500 grams without scoop.
containers of SEACURE® for pets Chewables, 120 chewable tablets.

CUSTOMER INFORMATION:

NOTE: All fields marked with an * are REQUIRED!

First Name:* ______________________________________________________________

Last Name:* ______________________________________________________________

e-mail address* ____________________________________________________________

Address Line1* ____________________________________________________________

Address Line2 _____________________________________________________________

City* ____________________________________________________________________

Province/Territory* _________________________________________________________

Postal Code* _____________________________________________________________

CANADA

Work or Home Phone Number _______________________________________________

SHIPPING INFORMATION:

We offer US Postal Service International Air Mail delivery to Canada which usually takes 12 to 14 days. If you need your order more quickly, we offer US Postal Service Express Mail with a 5 to 6 day delivery to most areas of Canada.

I want ________________________________________________ shipping for my order (Please fill in the type of shipping that you want).

PAYMENT INFORMATION:

You can pay for your order with your credit card OR you can pay by personal check or money order. We will have to wait for personal checks to clear our bank (about 1 week) before we can ship the order.

CREDIT CARD PAYMENTS

Credit Card Type: (fill in one circle)
Visa MasterCard American Express Discover

Credit Card Number: ______________________________________________________

Expiration Date (Month/Year): ______________________________________________

Name of the person as it appears on the credit card (REQUIRED):

_________________________________________________________________________

MONEY ORDERS/PERSONAL CHECK PAYMENTS

Check this box if you are paying by money order or personal check.

Please make the money order or personal check payable to NATURE DOC in US dollars. Do not forget to include the cost of shipping. You can obtain a money order from the post office (Canada Poste) when you mail in your payment. Money orders are processed faster than personal checks. Personal checks must first clear our bank unless you have placed an order with us before. Include your money order or personal check with this form when you mail it to NATURE DOC. There is a $20.00 US NSF Fee for returned personal checks.

Comments/Suggestions:


USE THE PRINT OPTION ON YOUR BROWSER TO PRINT A COPY OF THIS FORM. FILL IT IN AND MAIL THE COMPLETED FORM TO US.

Return to SEACURE-PROTEIN order page for Canadian customers.

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1-817-607-8531 (Office)
SEACURE® is a registered trademark of Proper Nutrition, Inc.

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