CALL 1-800-427-6767 FOR  MORE INFORMATION

Health & Nutrition 2009 Order Form

We will contact you for the details on your customization.  

Thank you for your order.

Please provide the following contact information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail

Calendar Version & Pricing:

Quantity	100	500	1000	2500	5000
	$2.95	$1.79	$1.09	$0.99	$0.89	Over 5,000 - Call for pricing

(note: Calendar versions may not be combined for volume pricing)

English Version
QUANTITY


Spanish Version
QUANTITY


 

BILLING INFORMATION

	BILLING
Purchase Order #
Account Name
Credit Card

Note: To pay by credit card, check the box after "Credit Card". We will contact you for further information.
This is not a secure site for financial information.

 

	BILLING ADDRESS
Attention
Company
PO BOX Address
Street Address
City
State/Province
Zip/Postal Code
Country

           SHIPPING INFORMATION

        Choose one of the following options:

Ship to the location above
Ship to multiple locations
(Please send multiple delivery locations separately to royb@pmginc.biz)

            Special Instructions/Comments: We will contact you for information about your customization
            within 1 business day of submitting this form. If you do not hear from us, please call 1-800-427-6767.
           
 

                             Print a copy of this completed form for your records.
Click Submit to place your online order. If you do not wish to order online, print this form
                                                    and mail or fax it to :
                    Premier Marketing Group, P.O. Box 540, Manchester, ME 04351
                                                    Fax: 207-623-2380
                                    Questions? Call us at 1-800-427-6767

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