O2 Innovations CTA-08 - Manual (Page 15)

O2-B ™ Portable Oxygen Bar & Accessories
Order Form
Oxygen Is Beautiful ™
CUSTOMER INFORMATION (please print)
Name M.I. Last Name
Complete Street Address Apt. / Suite #
City State ZIP Code Daytime Phone Number
E-Mail
ORDER INFORMATION
Item # Item Quantity Regular Price Promo Code Total
CTA-08 O2-B™ Portable Oxygen Bar $ 699.00 each _____________ $ ____________
HS-100 Headset (includes 12 filters, 2 mouthpiece covers) $ 39.95 each $ ____________
HO-100 Headset Hose (6.5 feet) $ 14.95 each $ ____________
MF-100 Mouthpiece Filters (12 pack) $ 12.95 each $ ____________
AF-100 Air Intake Filter $ 12.95 each $ ____________
MC-100 Mouthpiece Covers (2 pack) $ 14.95 each $ ____________
RF-100 Rear Cabinet Filter $ 11.95 each $ ____________
SF-100 Side Cabinet Filter $ 11.95 each $ ____________
CD-100 Set of Relaxation CDs (6) $ 60.00 each set $ 29.95 each set $ ____________
OH-100 Aromatherapy (10 ML bottle) Bee Happy $ 18.00 each $ ____________
OC-100 Aromatherapy (10 ML bottle) Bee Calm $ 18.00 each $ ____________
SHIPPING & HANDLING
Shipping & Handling for the O2-B™ Portable Oxygen Bar is FREE in the Continental United States.
For all shipments of any product outside the Continental United States, call for shipping rates.
For all other items include $ 4.95 S/H EACH $_____________
PA Residents include 6% Sales Tax $_____________
Please Make Check or Money Order payable to: O
2
Innovations ™
Total Amount Due $___________
METHOD OF PAYMENT: DO NOT SEND CASH Allow 2-6 weeks for delivery
Check Money Order VISA Mastercard American Express Discover
Credit Card #: ______________________________________________________________________
CVM#:________ _______ Exp. Date: _____________
Card Holder’s Signature: ______________________________________________Name as it appears on card: ______________________________________________ (Please Print)
NOTE: No delivery to P.O. Boxes
or APO addresses.
Fax order to: 570-655-7710 or Place order form and payment in envelope and send to: O 2 Innovations ™ 600 Luzerne Avenue, West Pittston, PA 18643.
You may also order at www.o2-b.com or by calling 866-432-0202. Credit card orders only please. Prices subject to change without notice.
(This is the 3 or 4 digit code on the front
or back or your credit card)
8/
20
05
CUT ✁ ✁ ✁
14
Order Form
REMEMBER to order extra filters to keep
your O2-B™ Portable Oxygen Bar in top
condition for many years of happy, healthy
breathing! Try a different aromatherapy essential oil
and order an O2-B™ Portable Oxygen Bar for a friend!
CD-100 Set of Relaxation CDs (6)
OH-100 Aromatherapy
(10 ML bottle)
Bee Happy
OC-100 Aromatherapy
(10 ML bottle)
Bee Calm
MF-100 Mouthpiece Filters
(12 pack)
HS-100 Headset
CTA-08
O2-B ™ Portable Oxygen Bar
MC-100
Mouthpiece Covers
(2 pack)
RF-100
Rear Cabinet Filter
SF-100
Side Cabinet Filter
AF-100
Air Intake Filter
HO-100 Headset Hose