Order Form

Keep ItemQuantity Item # DescriptionPrice Extended
Price
1 Pure Shampoo $5.00 $5.00
1 Pure Conditioner $5.00 $5.00
1 Pure Shower Gel $5.00 $5.00
1 Pure Lotion $5.00 $5.00
1 Pure Bath Beads $5.00 $5.00
1 Pure Bubble Bath $5.00 $5.00
Total:

Shipping Method: Overnight     Second Day     Standard Mail

Credit Card Type: American Express     Mastercard     Visa    

Credit Card Number:     Expiration Date: /

Order Comments:

Contat Me!

Ameena Salahuddin, 2002
Last Updated: February 22, 2003
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