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Flexaway System mail order form

Hanna Ibes, Inc.
1011 S. Thompson St.
Jackson, Michigan 49203

*Money Orders are required from customers outside of the United States.

Please enter your contact information:

Name_______________________________________     Date_____________________

Address___________________________________________________________________

City________________________________ State_______________ Zip____________

Phone#________________________________

Email________________________________________________

Qty. Product Name Price Total
.
 Complete Kit - Includes ONE Flexer in carrying case, 6 months supply of regular bands and instructions. $49.00 .
.
 2 Complete Kits - TWO identical kits (spare or share) for Extra $10 $59.00 .
.
 Regular Bands - EXTRA Six-Months supply $9.95 .
.
 Heavier Bands - OPTIONAL - Not Included. Six-month supply $9.95 .
  Replacement Gel Cushions - Additional Replacements $4.95  
FOR THOSE WITH PRE-EXISTING LIP LINES, WE RECOMMEND THE LIPGUARDS BELOW
.
 LipGuards - Optional - One-Year Supply $9.95 .
 Shipping Chart . .
U.S.A. 15% of total order . .
Canada 18% of total order .Sub Total .
Other countries 20% of total order Michigan Residents add 6% tax .
    Total: .

Sorry, we cannot accept checks from orders outside of the United States.

Please make all checks or money orders out to HANNA IBES, INC. All orders will be held until check/money order has cleared. After clearing, orders will be promptly shipped.  Thank you for your order. Hanna Ibes, Inc.1011 S. Thompson St. Jackson, Michigan 49203