Mail / Fax Order Form
*Print this page, fill out all information, and send this form by mail or fax to:
PerfectWoman.com
5390 Overpass Rd Ste B
Santa Barbara, CA 93111

FAX: 805-681-8201

Name:

Address:

City:

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Country:

Phone:

Email:

Select one

Money Order / Cashiers Check (Payable to Cosmeceutical Technologies in US$ only)

Visa / MasterCard / American Express (circle one)

Credit Card Number:

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/  Signature: _________________________

Buy 2 jars of Enlargement Creams Get 1 jar Free
(3 Month Supply )

$209.85 $139.90

Buy 3 jars of Enlargement Cream Get 3 jars Free
(6 Month Supply )

$419.70 $209.85

Buy 6 jars of Enlargement Cream Get 6 jars Free
(12 Month Supply ) -- Free S & H

$839.40 $419.70

Single jar of Perfect Woman Enlargement Cream

Single bottle of Perfect Woman Toning and Firming Lotion

$39.95 $34.95

$104.85 $69.90

$209.70 $104.85

Cutis Vita 2oz - 1 Jar

$9.95

Subtotal:

$.

Shipping (US orders $9.95, international orders $24.95)

$.

Grand Total:

$.