Fax Credit Card
Orders to: 1-866-269-9768, email to: support@myfasthairgrowth.com, or mail in
MAIL ORDER TO: Gro-aut Solutions, 4718
Steven Hill Drive, Richmond, VA 23234
Billing
Address:
(Please PRINT Clearly)
Ship
To: (Only
if different than billing address)
Name:
Name:
*Street Address:
*Street Address:
City:
State:
City:
State:
Post
Code:
Post
Code:
Day
Phone:
Day
Phone:
Email
Address:
Quantity
Item
Description
Size
Unit Price
Total Price
Shipping
and Handling Chart
Order
Total
U.
S. A
Canada
Other
Up
to $9.99
$1
$3
$5
$10
to 24.99
$2
$4
$8
$25
to 49.99
$3
$5
$10
$50
to 74.99
$3.95
$7.95
$12.95
$75
to 99.99
FREE
$9.95
$14.95
$100
to 299.99
FREE
$14.95
$19.95
$300
and up
FREE
$24.95
$29.95
Total
Merchandise
Add Shipping
& Handling
Add Insurance
(Optional)
Subtotal
Insurance
is provided for U.S. orders $75 and over and International orders $100 and
over. Insurance is optional
for U.S. orders less than $75 and international orders less than $100 but
encouraged. Because of circumstances beyond our control after a package
leaves our office, lost
packages are not our responsibility.
Add U.S. insurance = $3. Add International insurance = $8.
VA State
Residents Add
5% Sales Tax
TOTAL
Note: A 10-day hold applies to all orders paid with a personal check
for check clearance with our bank.
PAYMENT
METHOD:
Payable in U.S. Funds** CHECK
MONEY
ORDER
VISA
MASTERCARD
DISCOVER AMERICAN
EXPRESS
**Credit Card
Number:
Expiration
Date:
Signature:
______________________________________________________ (Required on Credit
Cards Orders)
**Billing address above must be where
you receive your Credit Card statement**
Happy hair growing and many
blessings
Thank You for your Order!
FOR OFFICE USE
ONLY:DATE
RECEIVED:________________ DATE SHIPPED:_______________
Payment
Method CHECKClearance date __________MONEY ORDERCREDIT CARD