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.

Pricing for SEACURE® is as follows:

1 bottle for $29.95 with FREE shipping via US First Class Mail,
2 bottles for $57.90 ($28.95 each) with FREE shipping via US Priority Mail,
3 bottles for $83.85 ($27.95 each) with FREE shipping via US Priority Mail,
4 bottles for $107.80 ($26.95 each) with FREE shipping via US Priority Mail,
5 bottles for US $129.75 ($25.95 each) with FREE shipping via US Priority Mail.

Pricing for SEAVIVE® and INTESTIVE® is as follows:

1 bottle or box for $26.95 with FREE shipping via US First Class Mail,
2 bottles or boxes for $51.90 ($25.95 each) with FREE shipping via US Priority Mail,
3 bottles or boxes for $74.85 ($24.95 each) with FREE shipping via US Priority Mail,
4 bottles or boxes for $95.80 ($23.95 each) with FREE shipping via US Priority Mail or
5 bottles or boxes for $114.75 ($22.95 each) with FREE shipping via US Priority Mail.

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 $80.85 (2 bottles of SEACURE® at $27.95 each and 1 box of INTESTIVE® at $24.95) 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 OR with your personal check.

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):

________________________________________________________________________

PERSONAL CHECK PAYMENTS

Check this box if you are paying by personal check. Include your check with this form. Please make your check payable to NATURE DOC.

Comments/Suggestions:


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