Natural Products Order Form

*Name:
*Street Address:
*City:
*State:		*Zip:
*Phone Number:
*Email:
Complete Product Name: (Please include manufacturer name and quantity)

Thank you for your online order! We will be calling you for your credit card information.

Shipping rates effective September 1, 2008:

$3.00 for orders up to $49.00
$5.00 for orders $50.00 - $149.99
Free shipping on all orders $150.00 and up

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Send your questions/comments about the website to Northwestern Health Sciences University Web Coordinator.