Printable Order Form
|
Product Catagory: -Weight Management- |
Qty. | Price: | |
|---|---|---|---|
|
Thermo Herbal Tea -Bottle |
- | $49.95 | - |
| Thermo Herbal Tea -Packets (60 packets) | - | $64.95 | - |
| Thermo Java Trim® Extra Trim® Extra Bottle | - | $44.95 | - |
| Thermo Java Trim® Extra Trim® Extra Packets (60 packets) | - | $57.95 | - |
| Omni Trim® Extra Enhancer (90 capsules) Item# 3761 | - | $26.95 | - |
| NiteLite (15 fl. oz.) Item # 3001 | - | $41.70 | - |
| ChitoTrim (180 capsules) Item # 2301 | - | $49.95 | - |
| PhasoTrim® (60 capsules) | - | $39.95 | - |
|
Product Category:-Advanced Formulas- |
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| Qty. | Price: | Total: | |
| Omni® 4 (liquid vitamins 30-1oz. packets) Item # 1091 | - | $61.95 | - |
| Omni® 4 (liquid vitamins 32 fl.oz.) Item # 1101 | - | $50.95 | - |
| Omni4® with Glucosamine Packets ( 30 1oz. packets) | $69.95 | ||
| Omni4® with Glucosamine Bottles (32 fl. oz) | $54.95 | ||
| Immune Defense (8 fl.oz.) Item # 4821 | - | $31.95 | - |
| Omnishield® Antioxidant(90 capsules) Item #4071 | - | $27.95 | - |
|
Product Category:-Personal Care- |
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| Qty. | Price: | Total: | |
| Omni® Hair & Nails (60 capsules) Item # 4051 | - | $29.95 | - |
|
Product Category:-Vitality & Energy- |
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| ** Charge ** | Qty. | Price: | Total: |
| Charge (90 - Capsules) Item # 4211 | $30.95 | ||
| ORANGE Charge (bottle 16.9oz.) Item #4201 | $34.50 | ||
| GRAPE Charge (bottle 16.9oz.) Item # 3921 | - | $34.50 | - |
| GRAPE Charge (Packets 90 -.56oz.) Item # 393 | - | $126.00 | - |
| ORANGE Charge (Packets 90- .56oz.) Item #422 | - | $126.00 | - |
| Meallenium Bar™sChocolate Chip(24-1.5oz.bars)Item # 557 | - | $43.20 | - |
|
Product Category:-Food for Thought- |
|||
| ** Remind ** | Qty. | Price: | Total: |
| Remind (bottle 15.3oz.) Item # 3901 | - | $34.95 | - |
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Product Category-Strength & Conditioning- |
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| Qty. | Price: | Total: | |
| Omni® ProBulider™ (vanilla 26.50z.) Item # 3361 | - | $34.95 | - |
| Omni® Sport (berry flavor 14.8oz.) Item # 3821 | - | $52.95 | - |
|
Product Category: -Specialty Products- |
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| Qty. | Price: | Total: | |
| Omnitrition® Enzyme (90 capsules) Item # 4921 | - | $15.95 | - |
| Omnitrition® Phyto-Nutrients (90 capsules) Item # 4911 | - | $34.95 | - |
| Profactor® (60 capsules) Item # 4931 | - | $27.95 | - |
| Omnismart® Oral Chelates: (180 capsules) Item #2251 | $44.95 | ||
|
Product Category :-New Distributors- |
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| ** New Distributor Start-up Kit ** | Qty. | Price: | Total: |
| Distributor Start-up Kit, Item # 2002 | - | $25.95 | - |
| Subtotal: (total of all categories) | $__________ | |
|---|---|---|
| Sales Tax:(6% - MI State Only) | $__________ | |
| Shipping: (subtotal x 10%) | $__________ | |
| Grand Total: (sub+sales tax+shipping) | $__________ |
| Bill to: | Ship To: |
| Name:_______________ | Name:_______________ |
| Address:______________ | Address:______________ |
| City:_________________ | City:_________________ |
| State/Province:________ | State/Province:________ |
| Zip:__________________ | Zip:__________________ |
| Phone:_______________ | Phone:_______________ |
| E-mail:________________ | E-Mail:________________ |
Payments accepted:
cashier's check, money order, Visa and Master Card
Credit Card payments are processed through Pro Pay
Credit Card Information.
Credit
Card #:____________________________________________
Expiration Date:____________
CVV2:___________
~~ The CVV2 is a three-digit security code that is printed on the back of many Visa cards.
Signature:____________________________________________
(Orders
cannot be processed unless signed.)
I hereby declare that I am at least 18 years of age .
Please contact us for answers to any questions at:
1-877-583-0049
All orders are Priority Mail or UPS.
Please make cashier's check or money orders out to: Jessica Dean.
Mail To:
IWantOmni.com
16530 Jakes Rd. Lachine, MI 49753