Address State Email Card # Ex. Date

Name City ZIP Phone # Type

Product	Price	Qty	Total
Rub	5.99		0.00
Drip	5.99		0.00
Spray - 1 oz	5.99		0.00
Spray - 2 oz	6.99		0.00
Spray - 4 oz	9.99		0.00
Spray - 8 oz	12.99		0.00
Refill - 16 oz	19.99		0.00
Towel	2.99		0.00
Shipping	5.95		5.95
Tax	6.5%		0.00
Total			0.00

Dealer Code if you have one Update Total Purchase

Orders will be processed within 1-2 business days. You will receive a confirmation email immediatly after your purchase. If you do not get a confirmation email please feel free to contact us to confirm your order.