|NOTE: Please set ALL Margins at 0.50", Print Out, Fill Out, SIGN and Send To:|
774-D S. Chesterfield Rd.
Columbus, OH 43209-2683
Sales & Info/614-237-2590
Please accept my Order for __ BCX ULTRA Frequency Instrument(s). I understand that, if I am NOT satisfied with my purchase, the BCX ULTRA Frequency Instrument has a 30 day MONEY-BACK Guarantee. I also understand, if I'm returning the BCX ULTRA Frequency Instrument, that it must be returned in a SALEABLE Condition and that there will be a 20% Restocking Fee.
I'm enclosing: $__________ (DISCOUNT Price) + $__________ (2nd Day Air U.P.S., if applicable - see below) = $__________ (TOTAL Amount - please insert in the AMOUNT window on the ORDER FORM and also use this Form, if ACCESSORIES &/or additional Healing Tools are being ordered).
I hereby AGREE to the above and the following Terms and Conditions:
Signature + Name (print clearly) Date