Mail Order Form

Please mail a copy of this form with your cheque,money order, or credit card number to: Goger Innovations Products, Inc., 1675 Cyrville Road, Unit 103, Ottawa, Ontario, Canada, K1B 3L7; or if you are ordering by fax, please fax a copy of this form to 613-741-8753. Fax or e-mail orders are accepted by credit card payment only, otherwise they will be processed upon receipt of your cheque or money order.

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:__(______)____________________________________________________
        (in case we have questions concerning your order)

Email: _________________________________________
Solution Graphics

Method of Payment: Card No._____________________
VISA (___) MASTERCARD (___) DISCOVER (___)
AMERICAN EXPRESS (___) PAYPAL (___)
Expiry Date: ____________________
Cheque: (___) Money Order: (___)   C.O.D. (within Canada only): (___)

Quantity: (___)

Chin Muscles Tonifier Total Cost per Country of Residence

Canadian Residents

  • Quantity: 1 Chin Muscles Tonifier
  • Size: Standard Fully Ajustable
  • Price: $129.95
  • Shipping and Handling: $15.00 (via CANADA Post)
  • subtotal: $144.95
  • Total:
    Total cost with tax(es)*
    PriceShipping &
    Handling    		Tax(es)*Total $CADProvince
    $129.95$15.00 $7.25$152.20AB, MB, NU, PE, QC, SK, NT, YT
    $17.39$162.34BC
    $18.84$163.79NB, NL, ON
    $21.74$166.69NS
    Tax amount is GST or HST, depending on destination province

U.S.A. Residents

  • Quantity: 1 Chin Muscles Tonifier
  • Size: Standard Fully Ajustable
  • Price: $149.95 Canadian Dollars
  • Shipping and Handling: $23.30 Canadian Dollars
  • Total Price $173.25 Canadian Dollars

Outside North America Residents - Europe, South America, Carribean, Japan, Australia, New Zealand, Malaysia, Singapore, Hong Kong, Taiwan and South Korea

  • Quantity: 1 Chin Muscles Tonifier
  • Size: Standard Fully Ajustable
  • Price: $149.95 Canadian Dollars
  • Shipping and Handling: $67.67 Canadian Dollars
  • Total Price $217.62 Canadian Dollars

Africa and Countries not listed above Residents

  • Quantity: 1 Chin Muscles Tonifier
  • Size: Standard Fully Ajustable
  • Price: $149.95
  • Shipping and Handling: $108.77 Canadian Dollars
  • Total Price $258.72 Canadian Dollars

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, Discover, AmericanExpress, etc. ).

NOTA: Catalog Company Orders are welcomed. Please call or write to enquire.

Next Page

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: