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FACSIMILE TRANSMITTAL SHEET |
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| TO: |
HELENE SILVER |
FROM: |
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| COMPANY: |
INNER BEAUTY INSTITUTE |
DATE: |
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| FAX NUMBER: |
707-933-9378 |
TOTAL NUMBER OF PAGES
INCLUDING COVER: |
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| PHONE NUMBER: |
707-933-9378 | 415-332-6566 |
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QTY |
Product |
Price |
Total |
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The Body Smart System |
$25 (includes shipping) |
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Rejuvenate |
$25 (includes shipping) |
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TOTAL |
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| Payment Type:
Credit Card Check (mail form
and check to P.O. Box below) |
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Credit Card Type: |
Visa Master Card |
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Card Number: |
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Exp: |
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| CUSTOMER NAME: |
| ADDRESS: |
| CITY/STATE/ZIP |
| PHONE: |
| YOUR EMAIL: |
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