Order Form
Print, Fax or Mail In Your Honest Diet Pills Order
Fax to: 941-485-3145 Or, Mail it to:
| Name: | _________________________ | City: | _________________________ |
| Email: | _________________________ | State: | _________________________ |
| Address: | _________________________ | Country: | _________________________ |
| Phone: | (____) ______ - ____________ | Zip: | _________________________ |
| MeltRX 24 Ultra®: | _____ @ $54.00 | = $ __________ |
| MeltRX 24 Ultra® (Buy 2 Get 1 Free): | _____ @ $108.00 | = $ __________ |
| MeltRX 24 Ultra® (Buy 3 Get 2 Free): | _____ @ $162.00 | = $ __________ |
| MeltRX 24 Ultra® (Buy 5 Get 4 Free): | _____ @ $270.00 | = $ __________ |
| Slenderizer™: | _____ @ $39.95 | = $ __________ |
| Slenderizer™ (Buy 2 Get 1 Free): | _____ @ $79.90 | = $ __________ |
| Slenderizer™ (Buy 3 Get 2 Free): | _____ @ $119.85 | = $ __________ |
| Slenderizer™ (Buy 5 Get 4 Free): | _____ @ $199.75 | = $ __________ |
| CarboRid™: | _____ @ $24.95 | = $ __________ |
| CarboRid™ (Buy 2 Get 1 Free): | _____ @ $49.90 | = $ __________ |
| CarboRid™ (Buy 3 Get 2 Free): | _____ @ $74.85 | = $ __________ |
| CarboRid™ (Buy 5 Get 4 Free): | _____ @ $124.75 | = $ __________ |
| Ultimate Cleanse & Burn Weight-Loss Kit (1 Kit) | _____ @ $97.95 | = $ __________ |
| Colon Cleanse Ultra™: | _____ @ $25.95 | = $ __________ |
| Colon Cleanse Ultra™ (Buy 2 Get 1 Free): | _____ @ $51.90 | = $ __________ |
| Colon Cleanse Ultra™ (Buy 3 Get 2 Free): | _____ @ $77.85 | = $ __________ |
| Colon Cleanse Ultra™ (Buy 5 Get 4 Free): | _____ @ $129.75 | = $ __________ |
| BioMazing™ HCG Drops (1 Bottles): | _____ @ $99.95 | = $ __________ |
| BioMazing™ HCG Drops (2 Bottles): | _____ @ $150.00 | = $ __________ |
| BioMazing™ HCG Drops (3 Bottles): | _____ @ $299.85 | = $ __________ |
| BioMazing™ HCG Drops (4 Bottles): | _____ @ $240.00 | = $ __________ |
| LipoRid PM™ | _____ @ $29.95 | = $ __________ |
| LipoRid PM™ (Buy 2 Get 1 Free): | _____ @ $59.90 | = $ __________ |
| LipoRid PM™ (Buy 3 Get 2 Free): | _____ @ $89.85 | = $ __________ |
| LipoRid PM™ (Buy 5 Get 4 Free): | _____ @ $149.75 | = $ __________ |
| Fat Blaster™: | _____ @ $44.95 | = $ __________ |
| Fat Blaster™ (Buy 2 Get 1 Free): | _____ @ $89.90 | = $ __________ |
| Fat Blaster™ (Buy 3 Get 2 Free): | _____ @ $134.85 | = $ __________ |
| Fat Blaster™ (Buy 5 Get 4 Free): | _____ @ $224.75 | = $ __________ |
| Hoodoba® Pure Hoodia 750: | _____ @ $54.00 | = $ __________ |
| Hoodoba® Pure Hoodia 750 (Buy 2 Get 1 Free): | _____ @ $108.00 | = $ __________ |
| Hoodoba® Pure Hoodia 750 (Buy 3 Get 2 Free): | _____ @ $162.00 | = $ __________ |
| Hoodoba® Pure Hoodia 750 (Buy 5 Get 4 Free): | _____ @ $270.00 | = $ __________ |
| Internal Body Cleanser™: | _____ @ $39.95 | = $ __________ |
| Internal Body Cleanser™ (Buy 2 Get 1 Free): | _____ @ $79.90 | = $ __________ |
| Internal Body Cleanser™ (Buy 3 Get 2 Free): | _____ @ $119.85 | = $ __________ |
| Internal Body Cleanser™ (Buy 5 Get 4 Free): | _____ @ $199.75 | = $ __________ |
| SUB TOTAL | = $ __________ | |
| Shipping & Handling | = $ __________ | |
| TOTAL | = $ __________ | |
Shipping Options:
- Standard First-Class Mail via US Postal Service is FREE on orders over $100 (Domestic Only)
- Standard First-Class Mail via US Postal Service just $9.95
- Upgrade to USPS Priority Mail Delivery for $9.95 (Average 1-3 business days — US ONLY)
- Upgrade to USPS Express Mail Delivery for only $39.95 (Overnight, most locations, (not available to APO, FPO) US ONLY)
- USPS Priority Mail International Delivery for $29.95 (Average 6-10 business days — INTERNATIONAL)
- Upgrade to USPS Global Air Mail Delivery for $99.95 (Average 3-5 business days — INTERNATIONAL)
- Hawaii, Alaska, Puerto Rico, US Virgin Islands, Guam: $12.95
( ) I am enclosing a check or money order for $____________
Please note: If you are paying by check you must make it payable to SHC, LLC and mail it in. We do not accept checks by fax.
( ) I want to charge this purchase to my Credit Card
Credit Card (check one):
VISA MasterCard American Express Discover
Card Number: _________________________
Expiry Date: _________ Signature: _________________________
I authorize SHC, LLC to charge $____________ to my credit card for the purchase (and shipment) of the above products.
Note: If you are using a credit card charges will show up on your statement under SHC, LLC which is our parent company. All orders will be shipped within 48 hours of receipt. Orders accompanied by checks will be held until cleared.