Please Phone, Mail or Fax to the Number below.
| Quantity for each Style and Size | |||||
| Size | Pant/Slack Size | #665 Preg Support (lite'N'cool) | #675 Preg Support (Cradle 'N' Lace) | #685 TummyTuck(Back_to_Normal) | |
| J | 1-3 | ||||
| P | 4-7 | ||||
| S | 8-10 | ||||
| M | 12-13 | ||||
| L | 14-16 | ||||
| XL | 18-20 | ||||
| XX | 22-24 | ||||
| X3 | 26-28 | ||||
| X4 | 30-32 | ||||
| X5 | 34-36 | ||||
| X6 | 38-40 | ||||
| Figure The Amount Due | ||||||
| Size | Price | X |
Qty. |
= | Total | *Delicat Cold Water Wash #6180-
Delicat is safe for bras, lingerie, nylons, baby cloths and delicate
fabrics, yet strong enough to remove stains, body oils and odors. This
formula will lengthen the life of all fine apparel and is the only product
recommended for washing our custom fitted bras and support garments. The
elastic will last longer. It is all natural, organic environmentally safe,
concentrated and economical to use.
|
| J | $56.00 |
X |
= | |||
| P | $60.00 | X | = | |||
| S | $61.00 | X | = | |||
| M | $68.00 | X | = | |||
| L | $70.00 | X | = | |||
| XL | $72.00 | X | = | |||
| XX | $73.00 | X | = | |||
| X3 | $74.00 | X | = | |||
| X4 | $76.00 | X | = | |||
| X5 | $76.00 | X | = | |||
| X6 | $76.00 | X | = | |||
| 5180* | $13.00 | X | = | |||
| Subtotal | $ | |||||
| Add S&H | $5.00 | |||||
|
Add $10 for 2nd day UPS |
$ | |||||
|
Local Sales Tax |
$ | |||||
|
Grand Total |
$ | |||||
Customer Information
Name:_________________________________________
______________________________________________
Address:_______________________________________
______________________________________________
City:___________________________________________
State:________________Zip:_______________________
Phone:_________________________________________
Email:__________________________________________
Payment Type: (Do NOT make payable to Jeunique)
[ ] Check or M.O.
Checks & M.O.
[ ] Debit
Card
payable to
[ ] Master
Card
CONSULTANT
[ ]
VISA
Total Amount Due
[ ]
Discover
$______________
[ ] Am. Express
Name on Card:
_______________________________________________
_______________________________________________
Card No:________________________________________
Exp. Date:________________________________________
Signature:
________________________________________________
[ ] Yes, I would like to be sized for a custom fitted bra (doubles
as maternity/nursing bra
Phone order to: (413) 532-5246
Fax order to: (413) 535-3070
Mail your order to:
Vicky Lynn Fanska
6 Bluemer Road
Southampton MA 01073
Email: dvfanska@earthlink.net