Slimnowamerica Fax Order Form
Use this form to place an order by mail, fax or click send to email to us. Fill it in on your computer and the form will calculate your total.
9882 Reading Ave
Garden Grove, CA 92844

Toll Free: 888-305-7575
Fax: (714) 775-4835

Payment Type:        Check   Money Order
Billing Information

Name:   (As shown on credit card)
Address 1:  
Address 2:  
City:      State:    ZipCode: 
Telephone:      Fax:
Email:  
Card Number  
Expiration:  
Signature:   << sign after printing
Shipping Information     Click here if shipping information is the same as billing information
Name:    
Address 1:  
Address 2:  
City:      State:    ZipCode: 
Telephone:      Fax:
Email:  
Order Items
UnitsProductUnit PriceCalculated
High performance slimming belt - BLue$160.00 $120.00
High performance slimming belt - Orange$160.00 $120.00
High performance slimming belt - Green$160.00 $120.00
Đàn Ông$15.00 $9.00
Chuyện T́nh Không Đoạn Kết$15.00 $9.00
Lính Xa Nhà$15.00 $9.00
Tiền Và Lá$15.00 $9.00
Tuyết Lạnh$15.00 $9.00
Em Vẫn Chờ Anh$15.00 $9.00
Em Tôi$15.00 $9.00
T́nh Yêu Màu Hoa Tím$15.00 $9.00
Tiếng Ca đó Về Đâu$15.00 $9.00
Mất Nhau Rồi$15.00 $9.00
Ngày Đó$15.00 $9.00
C̣n Nhớ Sài G̣n Không$15.00 $9.00
Gịng Lệ$15.00 $9.00
Bội Bạc$15.00 $9.00
Deposit charge$105.05
TRỌN BỘ MÁY LÀM ĐẸP - (BEAUTY COMBO)$190.00 $150.00
Máy Lắc Khí Công$179.00
Note:
Shipping cost:
Total: