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Please mail a copy of this form with your cheque,money order, or
credit card number to:
Please see the total amount
for your order below this form. Write your cheque or money order to Goger Innovation Products Inc.
Note:For clearance reasons, Canada order paid by cheque will only
be shipped 2 weeks after deposited and outside Canada ( International ) order paid by cheque will be shipped 4 weeks
after deposited.
I. SHIPPING ADDRESS
Name: __________________________________________________________
Street address: ___________________________________________________
City: __________________________________________________________
State/Province:______________________________________________________
ZIP/P.C.: __________________________________________________________
Country:_______________________________________________________________
Phone:__(______)____________________________________________________
Email: _________________________________________
Method of Payment: Card No._____________________
Quantity: (___)
Chin Muscles Tonifier Total Cost per Country of
Residence
Canadian Residents
U.S.A. Residents
Outside North America Residents - Europe, South America, Carribean, Japan, Australia, New Zealand, Malaysia, Singapore, Hong Kong, Taiwan and South Korea
Africa and Countries not listed above Residents
NOTE: If you want to know the exact price cost for the Chin Muscles Tonifier in
U.S. Dollars or in your local currency, please contact any bank or credit card company in your Country ( Visa, MasterCard,
AmericanExpress, etc. ).
NOTA: Catalog Company Orders are welcomed. Please call or write to
enquire.
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| 1 Back to Table of Contents 2 Online Order Form |
| To Order by Phone: | Call Toll Free: 1-800-265-8117 (Canada and USA)
Tel: 613-741-8229 (Overseas) Fax: 613-741-8753 (24 hours a day) Email: |