| JavaFit Order by Mail Form | ||||
| Print and mail this document to: | ||||
| JavaJosh.com, c/o Case Plants, PO Box 13525, Columbia, SC 29201 | ||||
| PAID to: Josh d'Marque | ||||
| Full Name: | ||||
| Street address : | ||||
| City: | ||||
| Phone: Fax: | ||||
| E-mail: | ||||
| Order Form: | Qty: | Price: | Total: | |
| JavaFit Original Roast - 1 Box ( 24 packets = 24 Pots Coffee ) | @ | $35.00 | ||
| JavaFit Original Roast - 1 single pack ( 1 Pot Coffee) | @ | $1.50 | ||
| JavaFit Diet Plus - 1 Box ( 24 packets = 24 Pots Coffee ) | @ | $55.00 | ||
| JavaFit Diet Plus - 1 single pack ( 1 Pot Coffee) | @ | $3.00 | ||
| JavaFit Extreme Energy - 1 Box ( 24 packets = 24 Pots Coffee ) | @ | $55.00 | ||
| JavaFit Extreme Energy - 1 single pack ( 1 Pot Coffee) | @ | $3.00 | ||
| JavaFit Immune Plus with Multi - 1 Box ( 24 packets = 24 Pots Coffee) | @ | $55.00 | ||
| JavaFit Immune Plus with Multi - 1 single pack ( 1 Pot Coffee) | @ | $3.00 | ||
| JavaFit Focus Plus with Multi - 1 Box ( 24 packets = 24 Pots Coffee) | @ | $55.00 | ||
| JavaFit Focus Plus with Multi - 1 single pack ( 1 Pot Coffee) | @ | $3.00 | ||
| Shipping and handling ( Continental US Only ) | Free | |||
| Total: | ||||
| All prices are in US dollars. | ||||
| Message or Special Instructions: | ||||
| Information Package? Yes or No (Please Circle) | ||||
| Funds must clear bank before shipment will be made. | ||||
| Josh d'Marque ▲ (803) 206-3091 ▲ www.JavaJosh.com | ||||