O2-innovations CTA-08 Manuel d'utilisateur télécharger pdf (Page 15)

O2-B

™

Portable Oxygen Bar & Accessories Order Form

Oxygen Is

eautiful

™

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 Ar

omatherapy (10 ML bottle) Bee Happy $ 18.00 each $ ____________

OC-100 Ar

omatherapy (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 Ta

x $_____________

Please Make Check or Money Order payable to: O

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 addr

esses.

Fax order to: 570-655-7710 or Place order form and payment in envelope and send to: O

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

)

8/2005

CUT ✁ ✁ ✁

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

1 2 ... 10 11 12 13 14 15 16 17

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O2-innovations CTA-08 Manuel d'utilisateur Page 15

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