Delivery Across the United States Credit Cards

Please print out the following information and mail it to us with your check or money order.

Name:   Date:  
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Product Description Quantity Unit Price Total Amount
Lacteeze Drops - bottle   USD$9.00/bottle  
Lacteeze Drops - case   USD$96.00/case  
Lacteeze Drops (15.5ml) - bottle   USD$14.00/bottle  
Lacteeze Drops (15.5ml) - case   USD$156.00/case  
Extra Strength Lacteeze Tablets - bottle   USD$11.50/bottle  
Extra Strength Lacteeze Tablets - case   USD$120.00/case  
Lacteeze Ultra (32 Tablets/bottle)   USD$8.99/bottle  
Lacteeze Ultra (60 Tablets/bottle)   USD$10.79/bottle  
Children's Lacteeze Tablets - bottle   USD$10.00/bottle  
Children's Lacteeze Tablets - case   USD$102.00/case  
Total Product Cost $
Shipping $
Total Amount $
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