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PO3 customer details

BODY BALANCE ORDER FORM

Recommended By: Simon & Masayo Smith 124133

Need help Contact Simon & Masayo

CONTACT DETAILS

[ * required field ]

First Name *

Last Name *

Email *

Mobile Phone *

DELIVERY DETAILS

Address *

Address you would like your product delivered to...... Yes a PO Box is okay

City

Postcode

Country

PRODUCT ORDER

2 PACK
2 x bottles of Body Balance (960ml) or 16 individual stick packets of powdered Body Balance.

4 PACK
4 x bottles of Body Balance (960ml) or 32 individual stick packets of powdered Body Balance.

8 PACK
8 x bottles of Body Balance (960ml) or 64 individual stick packets of powdered Body Balance.

Quantity of Body Balance *

2 Pack = 2 x bottles of Body Balance (960ml) or 16 individual stick packets of powdered Body Balance.
4 Pack = 4 x bottles of Body Balance (960ml) or 32 individual stick packets of powdered Body Balance.
8 Pack = 8 x bottles of Body Balance (960ml) or 64 individual stick packets of powdered Body Balance.

2 Pack BB = $65.70

4 Pack BB = $129.60

8 Pack BB = $247.20

24 Pack BB = $630.00

Choose Liquid or Powder *

Liquid

Powder

TERMS

I understand and agree to the following......

* by ordering ANY of the Body Balance packs I will be automatically signed up to a monthly autoship as per the Polices & Procedures

Terms Acknowledgement *

Yes

PAYMENT DETAILS

Credit Card Type *

Click the type of credit card you wish to use

Visa

Mastercard

Amex

Card Number *

When using your mobile you will be given the option to scan your credit card. If you don't have it hit the ADD Manually

Expiry *

MM/YY

CSV *

For Amex this is XXXX found on front of card. For all other cards this is last 3 digits on back of card.

* this order will be processed on next business day. All prices are shown and charged in Australian dollars.

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