Heather's Tummy Care MAIL ORDER FORM – Heather's Tummy Care "19203 70th Ave S, Kent, WA 98032 USA" help@helpforibs.com USA toll-free phone order line: 1-866-640-4942 Direct line: 1-206-264-8069 Fax: 1-206-264-8072 INDIVIDUAL ITEMS ORDERED: Eating for IBS $15.29 Quantity ______ Subtotal ______ First Year: IBS $15.29 Quantity ______ Subtotal ______ First Year: Crohn’s $16.16 Quantity ______ Subtotal ______ Heather Cooks! DVD $13.46 Quantity ______ Subtotal ______ Peppermint Caps (2 bottles) $23.95 Quantity ______ Subtotal ______ Hot Packs (2) $12.51 Quantity ______ Subtotal ______ Peppermint Tea Loose $15.25 Quantity ______ Subtotal ______ (Bulk Pouch 1 lb.) Peppermint Tea Loose $11.66 Quantity ______ Subtotal ______ (5 oz. Canister) Peppermint Tea Bags $11.65 Quantity _____ Subtotal _____ "(36 Jumbo Bags, 4.2 oz. Can)" Fennel Tea Loose $11.66 Quantity ______ Subtotal ______ (Bulk Pouch 1 lb.) Fennel Tea Loose $12.55 Quantity ______ Subtotal ______ (16 oz. Canister) Fennel Tea Bags $12.55 Quantity _____ Subtotal _____ "(45 Jumbo Bags, 8.8 oz. Can)" Acacia Fiber Bulk Pouch 1 lb. $16.95 Quantity ______ Subtotal ______ Acacia Fiber Can 1 lb. $17.95 Quantity ______ Subtotal ______ Acacia Fiber Travel Packets $14.31 Quantity ______ Subtotal ______ (2 boxes) Acacia Fiber Travel Packets CASE $63.60 Quantity ______ Subtotal ______ (10 boxes) DISCOUNT KITS ORDERED Acacia Tummy Fiber Kit $46.58 Quantity______ Subtotal ______ "(includes 3 items: 1 lb. Acacia Fiber Bulk Pouch, 1 lb. Acacia Can," 2 boxes Acacia Fiber Travel Packets) Diet Kit #1 $50.18 Quantity______ Subtotal ______ "(includes 3 items: Eating for IBS, 8.8 oz. Can Fennel Tea Bags, " 2 bottles Peppermint Caps) Diet Kit #2 $55.28 Subtotal ______ "(includes 3 items: Eating for IBS, 1 lb. Acacia Can, 2 bottles " Peppermint Caps) Kitchen Kit $44.96 Quantity______ Subtotal ______ "(includes 3 items: Eating for IBS, Heather Cooks! DVD," 1 lb. Acacia Can) Tummy Teabag Kit $45.90 Quantity______ Subtotal ______ "(includes 3 items: 4.2 oz Can Peppermint Teabags, 8.8 oz. Can Fennel Tea Bags, " 2 bottles Peppermint Caps) Bulk Herb Kit $48.45 Quantity______ Subtotal ______ "(includes 3 items: 1 lb. Bulk Pouch Organic Fennel Tea, 1 lb. Bulk Pouch Organic " "Peppermint Tea, 2 bottles Peppermint Caps)" Special Herb Kit $45.90 Quantity______ Subtotal ______ "(includes 3 items: 16 oz. Can Organic Loose Fennel Tea, " "5 oz. Can Organic Loose Peppermint Tea, 2 bottles Peppermint Caps)" Starter Kit #1 $47.54 Quantity______ Subtotal ______ "(includes 3 items: Eating for IBS, 1 lb. Can Organic Acacia, " First Year: IBS) Big Kahuna Kit $97.43 Quantity______ Subtotal ______ "(includes 7 items: Eating for IBS book, The First Year: IBS book," "8.8 oz. Can Fennel Tea Bags, 4.2 oz. Can Peppermint Tea Bags, 2 Hot Packs," "1 lb. Can Organic Acacia Fiber, 2 Bottles Peppermint Caps)" Tummy Fiber Acacia Senegal BULK KIT $48.32 Quantity______ Subtotal ______ (includes 3 - 1 pound pouches) Peppermint Caps BULK KIT $69.10 Quantity______ Subtotal ______ (includes 6 bottles of Peppermint Caps) Peppermint Tummy Teabags BULK KIT $33.02 Quantity______ Subtotal ______ (includes 3 cans of Peppermint Teabags - 108 jumbo bags total) Fennel Tummy Teabags BULK KIT $35.57 Quantity______ Subtotal ______ (includes 3 cans of Fennel Teabags - 135 jumbo bags total) SHIPPING: "USA - All shipping is via USPS Priority / First Class Mail, 2-5 business days" $5.97 for first item $9.97 for two or more items There is no additional shipping charge for more than two items. Shipping costs a maximum of $9.97 no matter what. USA - SPECIAL SHIPPING RATES APPLY TO THE KITS: "Each Kit is counted not as a single item, but as the total number of items" in the Kit. "CANADA - All shipping is via Airmail, 7-10 business days " "Canada $21.95 for the first item, plus $3.00 for each additional item " Shipping surcharge of $2.00 per can for Acacia & Teas in canisters INTERNATIONAL - All shipping is via Airmail 7-10 business days "International $25.95 for the first item, plus $6.00 for each additional item" Shipping surcharge of $3.00 per can for Acacia & Teas in canisters CANADA & INTERNATIONAL - SPECIAL SHIPPING RATES APPLY TO THE KITS: "Each Kit is counted not as a single item, but as the total number of items" "in the Kit. In addition, there is a $1.25 shipping surcharge for each Kit" containing three or more items. Shipping ______________ Items plus Shipping Subtotal __________ TAX: 9.9% tax (on items & shipping) for WA State shipping addresses only Tax ___________ Order Total ___________ PLEASE NOTE: If you have trouble determining the correct dollar amount for your order please "call us (toll free 866 640 4942, direct 206 264 8069) or email us (Help@HelpForIBS.com) and " we will help you. Checks or money orders received for amounts greater than the actual invoice "amounts WILL NOT have the overage refunded, so please be sure you send a check or money order " for the correct amount due. BILLING ADDRESS __________________________________________________________________ Name __________________________________________________________________ Street Address _______________________________ ________ ___________ ____________ City State/Province Zip Code Country _________________________ ________________________________________ Daytime Phone Number Email (required to fill order) SHIPPING ADDRESS Check here _____ to ship this order to the billing address Or ship to: SHIPPING ADDRESS __________________________________________________________________ Name __________________________________________________________________ Street Address _______________________________ ________ ___________ ____________ City State/Province Zip Code Country _________________________ ________________________________________ Daytime Phone Number Email (required to fill order) PAYMENT INFORMATION ____ Money order or check in US dollars enclosed. _____M/C _____ Visa _____ American Express _____ Discover ________________________________________________________________________ Credit card number Expiration THANK YOU FOR YOUR ORDER! YOUR BUSINESS IS TRULY APPRECIATED. Heather's Tummy Care "19203 70th Ave S, Kent, WA 98032 USA" Help@HelpForIBS.com USA toll-free phone order line: 1-866-640-4942 Direct line: 1-206-264-8069 Fax: 1-206-264-8072