Mail Order Form

Please fill out this form completely, then click on the "Print Order" button below.  Sign the completed form and mail it to us.  Once your order arrives we will email you with confirmation that your order was received.  If you have any questions please Contact Us.

(Please Note, this form will NOT send information over the internet)

Purchaser Information

Name:
Address:
City:
State:
Zip:
E-Mail Address:
Day Phone: Please Use Format: xxx-xxx-xxxx
Website Ordered From:

Shipping Information If Different

Name:
Address:
City:
State:
Zip:

Order Information

Original DermaTend®

$49.95 Qty:
DermaTend® Ultra Kit $69.95 Qty:
2 DermaTend® Ultra Kit $79.95 Qty:
Please Select The Appropriate S&H Charges

Tax (NV. Residents Only (7.375%)
Total Order


Payments by Check or Money Order must be made payable to

Solace International

 

 
Signature:___________________________________Date:_________________
 
Print Name: __________________________________________
 
 Please fill out this form completely, then click on the "Print Order" button.
Sign the completed order form and and mail it to us at:
 
Solace International, Inc.
80 Continental Drive, Ste 101
Reno, NV, 89509
 

 

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Legal Disclaimer: Results may vary, and testimonials are not claimed to represent typical results. Results seen in testimonials are meant as a showcase of what the best, most motivated clients have done and should not be taken as average or typical results. These statements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. Please consult your physician before beginning any program. If there is a change in your medical condition, please notify your physician immediately.