Print this form, fill it out then mail it with your payment to:
Name:___________________________
Address:__________________________
City:________________State_______Zip______
Phone:(____)____-_____Ext____
Country:_________________________________
Ship To:
Item#
Description
Qty
Unit Price
Total
_____________________________________________________________________________________
up to $99.99..............................  add$10.00
$100.00 and up......................... add 15% of                         Merchandise Total. 

Other charges may vary if ordered more than one of the same item, due to the weight and price.
      

_______________________
Item Total
California Residents    Please Add 8.25%
Packing & Shipping Fee
Grand Total
_______________________
_______________________
_______________________
*You will receive a
   free mystery gift
        with your
     Mailing  order.
  Cynthia's Amazing Products
1126 N. Mountain Avenue #1015
           Ontario, CA 91762           
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Order Date: _____/_____/_____
Packing & Shipping Chart 
Mailing Order Form
*Please make sure all information is correct before you mail in your order. Your payment must accompany your mail in order form  And must be                                            payable to: Cynthia Salazar         
Please provide the following information,

*Please Pay By Check or Money Order
*Please allow 5-7 business days for checks to clear before your order to be processed. All Returned Checks are subject to a service charge of                                $35.00