“CIRCULATOR” FOOT MASSAGE MAT

ORDER FORM

for orders from the U.S.A.

            Please note: If you are a wholesale customer, contact us for wholesale pricing and opportunities.

 

Price is in U.S. dollars.

Please send me _______ F.M. Circulator® foot massage mat(s) at $39.95 each		$
Shipping & Handling: USD $19.95 one mat + $2.95 each additional
Total		$

 

I enclose full payment in the form of  cheque     money order   

Please make cheques and money orders payable to K. Baggio.

Name  ___________________________________________

Address  _________________________________________

____________________________________________

City  ____________________________________________

State  ___________________ Zip Code  _______________

Telephone  (        )_____-________    Fax  (        )_____-________

 

Signature ________________________________________________

 

 

                    Mailing address: The Circulator

c/o Baggio

6078 Old Church Rd.

Caledon East, ON

Canada L7C 1G6