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
Please accept my Order for __ WAVESHAPER™ Frequency Instrument. I understand that, if I am NOT satisfied with my purchase, the WAVESHAPER™ Frequency Instrument has a 30 day MONEY-BACK Guarantee. I also understand that, if I'm returning one or MORE Units, they must be returned in SALEABLE Condition and that there will be a 15% Restocking Fee.
I'm enclosing: $__________ (DISCOUNT Price - please see PRICE LIST) + $__________ (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 that 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