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MAIL Order Form
for International 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 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*____________________________________________________________________

County, State or Province (If Applicable) ________________________________________

Postal Code/ Number (If Applicable) ___________________________________________

Country* _______________________________________________________________

Work or Home Phone Number ______________________________________________


SHIPPING INFORMATION:

We offer US Postal Service International Air Mail delivery (about 14 to 21 days) to most countries. If you need your order more quickly, we offer US Postal Service Express Mail with 5 to 7 day delivery to most countries.

Please select the type of shipping that you want for your order:

US Postal Service International Air Mail
US Postal Service Express Mail

PAYMENT INFORMATION:

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):

_______________________________________________________________________

You can also pay for your order by International Money Order or Bank Draft if you do not have a credit card. Please make your money order or bank draft payable to NATURE DOC in US dollars and include it with this completed form.

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 International customers.

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SEACURE® is a registered trademark of Proper Nutrition, Inc.

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