BIOCIRCUITS

GENERAL RELAXATION SCREENS
ORDER FORM

To order your set of Relaxation Screens please fill in the following information, print and mail, along with check or money order for $69.90 total ($62.95 plus 6.95 shipping),
(For orders of 2 or more and/or outside the United States please email screens@gene5.com for discounts & shipping charges.)

TO:
Gene Chamberlain
10120 Dunbarton Dr.
Huntsville, AL 35803

Your Name:

Street Address:

City, State, & Zip:

 

 

Area Code & Phone Number:

* Email Address:

* Needed if you want delivery confirmation number

Satisfaction guaranteed or your money back.

Delivery should be within one week of receipt of money order. Checks might take two weeks longer to clear.

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