Mail In Order Form

1. Complete and print this form, or print a blank form for a friend!
2. Mail the completed form with your Check or Money Order to:
Miss Patty's, Inc. , P.O. Box 361723, Melbourne, FL. 32936-1723

Place an "X " in the box next to the quantity & grade you want to order.
One 1/2 ounce Jar Miss Patty's Herbal Pain Remedy $3.99 + $2.50 S&H = $6.49
Two 1/2 ounce Jar Miss Patty's Herbal Pain Remedy $7.98 + $2.50 S&H = $10.48
Six 1/2 ounce Jar Miss Patty's Herbal Pain Remedy $20.94 + $4.95 S&H = $25.89
One 2 ounce Jar Miss Patty's Herbal Pain Remedy $9.49 + $2.50 S&H = $11.99
Two 2 ounce Jar Miss Patty's Herbal Pain Remedy $18.98 + $4.95 S&H = $23.93
Three 2 ounce Jar Miss Patty's Herbal Pain Remedy $28.47 + $4.95 S&H = $33.42
Six 2 ounce Jar Miss Patty's Herbal Pain Remedy $54.00 + $10.95 S&H = $64.95
CHOOSE: Land Grade Or Marine Grade
1 Bottle Coral Calcium $7.99 + $2.50 S&H = $10.49
2 Bottles Coral Calcium $15.98 + $4.95 S&H = $20.93
3 Bottles Coral Calcium $23.97 + $4.95 S&H = $28.92
6 Bottles Coral Calcium $46.50 + $10.95 S&H = $57.45
12 Bottles Coral Calcium $90.00 + $13.95 S&H = $103.95
24 Bottles Coral Calcium $180.00 + $13.95 S&H = $193.95
One 15' Single Roll Hydrion pH Test Paper with Dispenser $7.99 + $2.50 S&H = $10.49
Two 15' Single Rolls Hydrion pH Test Paper with Dispensers $15.98 + $2.50 S&H = $18.48
Three 15' Single Rolls Hydrion pH Test Paper with Dispensers $23.97 + $2.50 S&H = $26.47
Four 15' Single Rolls Hydrion pH Test Paper with Dispensers $31.96 + $2.50 S&H = $34.46
5 Single Roll Dispensers Hydrion pH Test Paper + Five Refill Rolls $50.54 + $4.95 S&H = $55.49
Five Refill Rolls Hydrion pH Test Paper $12.99 + $2.50 S&H = $15.49
(Shipping to USA only)
First Name:
Last Name:
Address:
Address:
City:
State:
Zip Code:
Home Phone:
E-mail:
THANK YOU FOR YOUR ORDER
Orders paid with Business or Personal checks will be held for 7-10 days for check to clear.
Orders paid with Money Order will be shipped within two business days.
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