|
Derma Shield PlusTM
Order Form |
 |
|
|
Derma Shield Plus 2 oz. - $12.95 ea
|
~ 70 applications |
|
Derma Shield Plus 12 oz. - $29.95 ea
|
~ 421 applications |
| |
|
|
Derma Shield Plus 2oz.
(12
cans/case) $124.95 |
(Save $30.45) |
|
Derma Shield Plus 12oz.
(6
cans/case) $143.95 |
(Save $35.75) |
| |
|
|
Shipping and
handling within the Continental US charged as follows:
1 to 4 Items. . . . . . . $8.00
5 to 11 Items. . . . . . $12.00
12 and up . . . . . . $18.00 |
To
place your order, please complete the form below to gives us your
shipping information and then click "Submit" at the bottom. You will
then be taken to a secure payment page where you can submit your
payment via credit card or PayPal. Product can only be shipped in
the contiguous USA. |
|
Your Contact and shipping Information |
|
Person or Representative
that
referred you to this
website: |
|
|
First Name:
|
|
|
Last Name:
|
|
|
Shipping Address:
|
|
|
City: |
|
|
State: |
|
|
Zip: |
|
|
Email Address: |
|
|
|
|
|
Choose Your Order: |
|
|
Derma Shield Plus 2 oz. - $12.95 ea: |
Number of 2 oz cans: |
|
|
Derma Shield Plus 12 oz. - $29.95 ea: |
Number of 12 oz cans: |
|
|
Derma Shield Plus 2oz. - $124.95: |
Number of 2 oz cases(12
cans / case): |
|
|
Derma Shield Plus 12oz. - $143.95: |
Number of 12 oz cases
(6 cans / case):: |
|
|
|
|
Comments: |
|
|
Comments: |
|
|
Spam prevention: Please
enter "SAVE" (ALL CAPS) in the block to the right. |
|
|
|
|
Click "Submit". You will then be taken to a secure payment page
where you can submit your payment via credit card or PayPal. Or, if
you would like to pay by check or by phone, call 864.278.0118 |
|
We Appreciate Your Business! |