FAX Order
Form
for US Military
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. Fax the completed form to us at 817-977-1240. We will process it right away and send your order to you within 24 hours (excluding weekends).
ORDERING INFORMATION:
Quantity
bottles of
SEACURE®, 180 capsules per bottle, 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.
Pricing for SEACURE®
is as follows:
1 bottle for $23.95 with FREE
shipping via US First Class Mail,
2 bottles for $47.90 ($23.95 each)
with FREE
shipping via US First Class Mail,
3 bottles for $71.85 ($23.95 each)
with FREE
shipping via US Priority Mail,
4 bottles for $91.80 ($22.95 each)
with FREE
shipping via US Priority Mail,
5 bottles for $109.75 ($21.95 each)
with FREE
shipping via US Priority Mail.
Pricing for SEAVIVE®
and INTESTIVE®
is as follows:
1 bottle or box for $23.95 with FREE
shipping via US First Class Mail,
2 bottles or boxes for $47.90 ($23.95
each) with FREE
shipping via US First Class Mail,
3 bottles or boxes for $71.85 ($23.95
each) with FREE
shipping via US Priority Mail,
4 bottles or boxes for $91.80 ($22.95
each) with FREE
shipping via US Priority Mail or
5 bottles or boxes for $109.75 ($21.95
each) with FREE
shipping via US Priority Mail.
Pricing for SEACURE®
for pets, 100 gram containers and SEACURE®
for pets Chewables, 120 chewable tablet containers is as follows:
1 or more containers for $23.95 each.
Pricing for SEACURE®
for pets, 500 gram containers is as follows:
1 or more containers at $99.95 each.
We do NOT offer volume discounts for the SEACURE® for pets products.
We will mix orders and give you the volume discount. For example, order
2 bottles SEACURE® of and 1 box
of INTESTIVE® and receive all
3 for the price of $71.85
(2 bottles of SEACURE®
at $23.95 each and 1 box of INTESTIVE®
at $23.95) with FREE
shipping via US Priority Mail!
CUSTOMER INFORMATION:
NOTE: All fields marked with an *
are REQUIRED!
First Name:* ______________________________________________________________
Last Name:* ______________________________________________________________
e-mail address* ____________________________________________________________
Address Line1* ____________________________________________________________
Address Line2 _____________________________________________________________
Military Post Office*
________________________________________________________
Military State* ____________________________________________________________
Zip Code* _______________________________________________________________
Contact Phone Number _____________________________________________________
PAYMENT INFORMATION:
You can pay for your order with your credit card (VISA, MasterCard, American Express or Discover).
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):
________________________________________________________________________
Comments/Suggestions: (if you have a stateside billing address, please type it into the comment box)
USE THE PRINT OPTION ON YOUR BROWSER TO PRINT
A COPY OF THIS FORM. FILL IT IN AND FAX THE COMPLETED FORM TO US AT 817-977-1240.
Return to SEACURE-PROTEIN order
page for US Military.
© 1999-2010 Seacure-Protein. All Rights
Reserved. 817-607-8531
SEACURE® is a registered trademark
of Proper Nutrition, Inc.
feedback@seacure-protein.com
