Print this form, fill it out then mail it with your payment to:
Name:___________________________
Address:__________________________
City:________________State_______Zip______
Phone:(____)____-_____Ext____
Country:_________________________________
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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.
California Residents Please Add 8.0%
* You will receive a
free mystery gift
with your
Mailing order.
Cynthia's Amazing Products
1126 N. Mountain Avenue #1015
Ontario, CA 91762
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Order Date: _____/_____/_____
* 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 $25.00