Distributor of Thermotex Infrared Heating Pads

 

Fill in all of the contact information, the quantity you wish to order and the totals of each line and bottom. Add the correct shipping according to the chart below and print the completed form. Mail form along with check or money order to the address below.

Please type in the information below before you print. It's much easier to read and will help eliminate errors. Thanks

First Name Last Name
Street Address
City State    Zip Code 
Home Phone E-Mail  
Mail Check and Form:  Payable To: Jade Enterprises
			          4301 32nd St W Ste B20
			          Bradenton, Fl. 34205
Product Name Quantity Price Each Total

 

Shipping

Subtotal:

Shipping:

 

    

 

Total

 

Jade Enterprises