Order Form

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Fax to: 1-800-701-4556 Or Mail it to: NGN C/O ReishiForce.com
Name: _________________________ City: _________________________
Email: _________________________ State: _________________________
Address: _________________________ Country: _________________________
Phone: (____) ______ - ____________ Zip: _________________________
1 Bottle Reishi Force - Home Delivery Plan _____ @ $47.00 = $ __________
2 Bottles Reishi Force + 1 FREE Bottle Reishi Force _____ @ $134.00 = $ __________
4 Bottles Reishi Force + 2 FREE Bottles Reishi Force _____ @ $268.00 = $ __________
1 Bottle Reishi Force _____ @ $67.00 = $ __________
SUB TOTAL = $ __________
Shipping & Handling = $ __________
TOTAL = $ __________
Shipping Options:
  • USPS Priority Mail Delivery is FREE on orders over $50.00 (Domestic Only)
  • Standard First-Class Mail via US Postal Service just $9.95
  • Upgrade to USPS Priority Mail Delivery for $9.95 (Average 1-3 business days — US ONLY)
  • Upgrade to USPS Express Mail Delivery for only $39.95 (Overnight, most locations, (not available to APO, FPO) US ONLY)
  • USPS Priority Mail International Delivery for $29.95 (Average 6-10 business days — INTERNATIONAL)
  • Hawaii, Alaska, Puerto Rico, US Virgin Islands, Guam: $12.95
( ) I am enclosing a check or money order for $____________ Please note: If you are paying by check you must make it payable to NGN and mail it in. We do not accept checks by fax. ( ) I want to charge this purchase to my Credit Card Credit Card (check one): VISA MasterCard American Express Discover Card Number: _________________________ Expiry Date: _________ Signature: _________________________ I authorize NGN to charge $____________ to my credit card for the purchase (and shipment) of the above products. Note: If you are using a credit card charges will show up on your statement under NGN which is our parent company. All orders will be shipped within 48 hours of receipt. Orders accompanied by checks will be held until cleared.   Click to Print This Page