Order Form

Order Form

Please print out and complete the order form. You may either mail it, fax it or call the order in. Methods of payment are limited to prepaid by check, money order, COD or major credit card.
Mail Order Form to:
Stuart Kalishman 17395 North Bay Road Suite # 206 Miami Beach, Florida 33160
Distributor Number 19635

Fax Order Number (305) 935-1040 Voice Order Telephone Number 1 (888) 272-3479

There are two ways to purchase our products. Retail customers, please use the first form below. If you would like to save up to 40%, beginning with your very first order, you may sign up as a wholesale buyer/distributor. Becoming a distributor is a very simple process. You validate your distributorship by placing your first initial wholesale order which will includes a fee for a one-time $19.00 charge for a Distributor Kit. That's all there is to becoming a distributor and take advantage of our discounted pricing. Please complete your order using the second order form below.

PRICE REDUCTION!!! NOW AVAILABLE IN CAPSULES! DO NOT PAY $125! SUGGESTED RETAIL PRICE IS $119.00.

DISTRIBUTORS, "PAY $19.00 FOR THE MOST INFORMATIVE AUDIO DISTRIBUTOR KIT
WHICH DOES THE SELLING FOR YOU AND YOU
CAN BUY PRO-Symbio PLUS FOR $79.00 OR LESS!"

ORDER DESK 1-888-272-3479
Distributor Number 19635 Terms & Conditions:

No health claims are made on this product.
Payment terms are pre-paid by check, money order, COD or Major credit card.

RETAIL ORDER FORM

Product Name & Description

Unit
Price

Qty

Total Cost ($US)

PRO-Symbio PLUS (1 month supply)

$125.00

PRO-Symbio PLUS - 3 Pack ($89 each)

$267.00

PRO-Symbio PLUS - 6 Pack ($79 each)

$474.00

Pro-Symbio HGH (original formula)

$150.00

Subtotal Amount ($US) for This Order

Sales Tax 6.5% (FL residents)

Shipping

48 Contiguous States 5% ($5 min, $75 max)

HI, AK, PR, CAN, MEX 15% ($15 min)

Western Europe 25% ($25 min) Other 30% ($30 min)

TOTAL AMOUNT ($US) FOR THIS ORDER

For ordering questions please call 1-888-272-3479

WHOLESALE ORDER FORM

Product Name & Description

Unit
Price

Qty

Total Cost ($US)

PRO-Symbio PLUS (1 month supply)

$79.00

PRO-Symbio PLUS - 3 Pack ($69 each)

$207.00

PRO-Symbio PLUS - 6 Pack ($59 each)

$354.00

Pro-Symbio HGH (original formula)

$99.00

Distributor Kit (first order only) $19.00

Subtotal Amount ($US) for This Order

Sales Tax 6.5% (FL residents)

Shipping

48 Contiguous States 5% ($5 min, $75 max)

HI, AK, PR, CAN, MEX 15% ($15 min)

Western Europe 25% ($25 min) Other 30% ($30 min)

TOTAL AMOUNT ($US) FOR THIS ORDER

Licensed Medical Professionals, please call for pricing. For ordering questions, or to inquire about other products please call 1-888-272-3479

VISA MASTERCARD AMERICAN EXPRESS Discover

ACCOUNT NUMBER:
EXPIRATION DATE:
NAME AS PRINTED ON CARD:

SHIPPING INFORMATION

*Name:
*Street:
*City:
*State and Zip Code:
*Country:
Soc Security/ID Number (New Distributors Only)
*Day Phone:
*Eve Phone:
Best Time to Call:
Fax:
E-mail Address

 *Orders without these items cannot be processed.

Questions or Comments?


For ordering questions

please call 1-888-272-3479

E-mail Your Questions Stuart Kalishman Distributor Number 19635 Miami , Florida
1-888-272-3479

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