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SHIPPING INFORMATION
Name: _________________________ Address: _________________________ _________________________ City/State: _________________________ Zip/Country: _________________________ Telephone: _________________________ E-Mail: _________________________ (in case we need to |
BILLING INFORMATION Name: _________________________ Address: _________________________ _________________________ City/State: _________________________ Zip/Country: _________________________ Payment Method: [ ]Bank Check (check one) |
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Card Number: ________________________ Exp Date: ________________________ Signature: ________________________ (make checks payable to Swiss Corrective Skin Care) ITEM / DESCRIPTION QUANTITY COST TOTAL ____________________________________________ __________ __________ __________ ____________________________________________ __________ __________ __________ ____________________________________________ __________ __________ __________ ____________________________________________ __________ __________ __________ ____________________________________________ __________ __________ __________ ____________________________________________ __________ __________ __________ Sales Tax: __________ FINAL TOTAL: __________ FAX completed orders to (818)-763-4660 Mail completed orders to Swiss Corrective Skin Care, P.O.Box 3881 Beverly Hills, Ca. 90212 USA Mail in your Bank Check or Money Order. |
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Copyright © 2006 Swiss Corrective Skin Care P.O. Box 3881 Beverly Hills,CA 90212 US Tel: 1-310-766-1002 EU Tel:Dr Kelemen Mártonné (36) 20 200 6525 |
All products are formulated and manufactured exclusively for Swiss Corrective Skin Care Beverly Hills No animal testing done. Available only from licensed professionals. |