BARLEYGREEN PRODUCTS ORDER FORM

This is a Secure Ordering Site.

1. Please type in requested quantity and total for each item.

2. Add shipping and handling charge.

3. California residents add 8.75% sales tax.

4. Add appropriate credit card information.
(Please note that your credit card statement will show charges from Green Foods, Inc.)

5. Click on SUBMIT ORDER. Ordering System is Secure.

6. Or you may print the order form and fax your order to 760-343-0765.

7. Or you may print the order form and send a check or money order made out to "Green Foods." Mail to:

Lorraine Day, M.D.
P.O. Box 8
Thousand Palms, CA 92276

Remember the check or money order must be made out to "Green Foods."

8. Phone Orders: Call 760-343-0965 M-Th between 9 AM and 4 PM, and 9:00 AM - 2:00 PM on Fridays (Pacific Time).

9. BarleyGreen products are available in the U.S. Only.

Shipping and Handling: The Shipping and Handling charges posted are for the lower 48 states of the U.S ONLY. Shipping and Handling charges for Alaska and Hawaii must be figured individually. All orders are shipped by UPS which REQUIRES a phone number and a street address. (We cannot ship to a P.O. Box.)

Please be sure to include your e-mail address.


PRODUCT TITLE COST QTY. TOTAL
BarleyGreen Premium™
$32.00
BarleyGreen Premium™ Caplets
$32.00
Beta Carrot $32.00
Beta Beet $32.00
       
Merchandise Total
The Shipping and Handling charges posted are for the lower 48 states of the U.S ONLY.
Shipping
(6% of Total)
Orders to be shipped to Alaska or Hawaii must be figured individually.
Handling Flat Rate
($6.00 flat fee)
Subtotal
CA residents only: Add sales tax of 8.75% on Subtotal
TOTAL

Main Contact Name*
Ship To Information
Name*
Ship To Address*
Street address only. No P.O. Box.
Address Line 2
City*
State*
Zip*
Billing Information (if different from Shipping information listed above)
Name
Address
Address Line 2
City
State
Zip

Phone* (required by UPS)
FAX
E-mail*

Credit Card Information
Please note that your credit card statement will show charges from Green Foods, Inc.
Credit Card* Mastercard
VISA
Name on Card*
Credit Card Number*
Exp. Date*
Security Code*
*Denotes Required Field

  



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