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EnergyPlates.com • 15508 W Bell Rd Ste 101-438 • Surprise,
Arizona 85374
• Phone: 1-877-877-0747 • Fax 1-623-321-9977 •
• E-Mail:
•
(Please Print)
See **Payment Method Below**
| Name | ||
| Street Address | ||
| City | State/Prov. | Postal Code |
| Email Address | Home
Phone ( ) |
Office
Phone ( ) |
| Shipping Address (if different) | ||
| City | State/Prov. | Postal Code |
§ This symbol denotes a special discounted item. No coupons or other offers are valid with discounted items.
| Item | Description | Quantity | Unit Price | Subtotal |
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PEP5
|
Positive Energy Plate (2¾" x 4½") |
$15.00
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PEP5X6
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Positive Energy Plate (2¾" x 4½") 6-pack | § |
$80.00
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PEP12
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Positive Energy Plate (12" x 12") |
$45.00
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PEP12X6
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Positive Energy Plate (12" x 12") 6-pack | § |
$240.00
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PEAS
|
Positive Energy Purple Angel Small (1 3/8" x 1 3/8") |
$10.00
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PEASX6
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Positive Energy Purple Angels 6-pack Small | § |
$54.00
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PEAL
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Positive Energy Purple Angel Large (2 1/8" x 2 1/8") |
$12.00
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PEALX6
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Positive Energy Purple Angels 6-pack Large | § |
$65.00
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PEDS
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Positive Energy Purple Disk Small (1" x 1") |
$7.50
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PEDSX6
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Positive Energy Purple Disks Small (1" x 1") 6-pack | § |
$36.00
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PEDL
|
Positive Energy Purple Disk (1½" x 1½") |
$7.50
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PEDLX6
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Positive Energy Purple Disk (1½" x 1½") 6-pack | § |
$36.00
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PEFF
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Positive Energy Fridge Freshener |
$30.00
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PETB
|
Green Thumb Positive Energy Tube |
$25.00
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PEFIS
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Positive Energy Fuel Ionizer (Small) |
$40.00
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PEFIL
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Positive Energy Fuel Ionizer (Large) |
$85.00
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PEPI
|
Positive Energy Pool Ionizer |
$300.00
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PEHC
|
Hunza Water Conditioner |
$200.00
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Coupon #: _____________________
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-$
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Comments:
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TOTAL:
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Shipping and Handling |
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USA |
International Shipping will be determined by Weight and Country at time of shipment. Please e-mail for final shipping charges. |
Thank you
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**PAYMENT METHOD**
Payment will only be accepted made
out to Scot Brown.
Please pay amount due in cash, check, or money order.
International orders payable in US Funds preferred
as a Money Order from your Post Office.
International Money Order also accepted. Please follow above note.