Nuphedrine
Mail Order Form
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Please print and fill out this form completely and mail it with your money order or bank draft in US dollars to:

C/O Nuphedrine
P.O. Box 1800
Canutillo, TX 79835
USA
Please note: We accept money orders (US dollars) only. Sorry, we do not accept cash, personal checks, electronic checks, PayPal or COD orders.
 
6 MONTH SUPPLY Nuphedrine x 3 boxes -$200 Savings $250.00
 
3 MONTH SUPPLY Nuphedrine x 2 boxes -$85 Savings $140.00
 
1 MONTH SUPPLY Nuphedrine x 1 box $75.00
Shipping Information:
Name:
 
Address:
 
City/State/Zip:
 
Telephone:
 
Email Address:
 
Amount Enclosed:
Write in the amount for the Nuphedrine supply you chose:
$
Shipping and Handling:
$
TOTAL ORDER IN US DOLLARS:
$