SANDUSKY'S HEALTH ALTERNATIVES ORDER FORM

If you wish to fill out this form we would retain your information in strict privacy for billing purposes and future contacts.
If you have any questions about our Privacy Policy please contact us at (403) 746-0006.

Please print out the order form and mail or fax to the following address with your order
(payable by cheque, money order, Visa, American Express or Mastercard).
Please note: All prices are in Canadian dollars.

Fish Symbol

Sanduskys' Health Alternatives P.O. Box 9041 Sylvan Lake, Alberta, Canada T4S 1S6    Fax: 1-800-615-1376


Personal Information                                                            Credit Card Information
Name:                                                                                 Phone: (      )

Email: 		VISA Number:                      
Address: M/C Number:
City:                               Prov:                       Postal Code: Expiry Date:


QUANTITY DESCRIPTION OF PRODUCT PRICE TOTAL
       
       
       
       
       
       
       
       

Sub Total___________

G.S.T. ___________

Total___________



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