Bio-Gulf International Corporation
Fax Order Form
Please complete, print and fax this Order
Form to:
(213) 559-0835 (For US Customers)
If you are dialing from a non-US location, you would have to dial:
++ 1 (213) 559-0835 (For Non-US Customers)
where "++" is your country's international access dialing code
Once your payment has been received and processed, we will send
you a notification via email.
| Description | Unit Price (US$) | Quantity | Total (US$) |
| Libidus (10 capsules per pack) | 39.95 |
|
|
| Libidus for Women (10 capsules per pack) | 39.95 |
|
|
| Libidus Penis Oil (60 ml) | 19.95 |
|
|
| Virgin Cream (2 jars) | 59.95 |
|
|
| Libidom (24 pieces per set) | 12.50 |
|
|
| Diaberlink (60 capsules per bottle) | 34.95 |
|
|
| Hair Plus (60 capsules per bottle) | 34.95 |
|
|
| Heart Plus (60 capsules per bottle) | 49.95 |
|
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Add Shipping & Handling Charges: US$7 for Registered Airmail or US$18 for Courier / Express Mail You MUST select a shipping option and add the shipping charges to your total or the products will not be shipped out. |
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| TOTAL |
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SPECIAL '2005' PROMOTION
Libidus:
Buy 2 packs, get a FREE bottle (30 ml size) of Libidus Penis Oil.
Buy 3 packs, get a
FREE pack of Libidus plus a FREE bottle (30 ml size) of Libidus Penis Oil.
Libidus for Women:
Buy 2 packs, get a FREE jar of Virgin Cream.
Buy 3 packs, get a FREE pack of Libidus for Women plus a FREE jar of Virgin Cream.
Virgin Cream:
Buy a 2-jar pack, get a another jar FREE.
PAYMENT BY (Please select one):
( ) Visa
( ) MasterCard ( ) Amex
Name on Credit Card:___________________________________________________________________________
Credit Card No:________________________________________________________________________________
Expiry Date:___________________________________________________________________________________
CCV2 No:_____________________________________________________________________________________
Signature:
____________________________________________________________________________________
BILLING INFORMATION (Please complete legibly in BLOCK LETTERS):
Name: _______________________________________________________________________________________
Address: _____________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
City: ___________________________________State: ______________________ Zip: ______________________
SHIPPING INFORMATION (Please complete legibly in BLOCK LETTERS):
Name: _______________________________________________________________________________________
Address: _____________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
City: ___________________________________State: ______________________ Zip: ______________________
Tel: __________________________________________Fax: ___________________________________________
Email: _______________________________________________________________________________________
TERMS AND CONDITIONS
Your order will not be shipped out UNTIL your credit card transaction has been approved by the bank.
You must have a valid email address in order for us to contact you.
You will receive an email from us once your order has been shipped out. The email will come from JIM, our Fulfilment Manager. VERY IMPORTANT: If you have an anti-spam software, please allow emails to come from xtreme2@singnet.com.sg, biogulf@singnet.com.sg and enquiry@biogulf.com or you will not be able to receive your tracking information and other important notification.