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________________    _____________________    _______

Last Name                   First Name                           MI

 

________________________________________________

Address

________________________________________________            

                 

Zip Code ___________ Phone (_______)______________

Please charge my (circle one)

□ MasterCard    □ Visa   □ Discover □ American Express

Card#____________________________ Exp(mm/yy)____

Security Code____ (last three digits on the back of the card)

 

Cardholder signature___________________ Date_______

If paying by check, please make it payable to: Simpro Inc.

(Please include driver’s license number on the check)

 

NatureSpiritâ Humidifier with Ionizer

UH601  _______  x  $49   =               $__________

UH602  _______  x  $99  =                $__________

TX residents add 8.25% sale’s tax     $__________

Total Amount Due                             $__________

 

Please mail your order to:

Simpro Inc. 2018 Primrose Dr, Irving, TX 75063

Order by fax: 972-830-9987

www.naturespiritproduct.com

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