Antiherpes.com · Money Order Form

Please print out this form, fill it in, and post with the money order to:
Antiherpes.com
501 Silverside Road, Suite 105, Wilmington, DE, 19809, USA
We do not accept cash, please ensure that you only send money orders.

First Name:

Surname:

Shipping
Address:

City:

State:

Zip Code:

Country:

Telephone:

Fax:

Email:

Please double check the email address. We need it to send a confirmation of the order.

Please supply me with the following Antiherpes Remedies:
Please note that 1 unit consist of a of a 4 weeks supply.

Units

Remedy

Price per unit in US$

Totals in USD$

Super H Ointment

$34.99

Please choose a shipping method

USA Shipping Methods (Shipped from the US)

		Total
USPS PRIORITY MAIL Shipping delivery within 3-10 days	$5.00
UPS Ground Shipping delivery within 3-6 days	$7.00
UPS 3 day shipping delivery within 2-5 days	$16.00
UPS Second day shipping delivery is 2 Business Days	$22.00
UPS Next Day shipping is 1 business day.	$40.00

International (Worldwide) Shipping methods

USPS delivery within 7-21 days	$12.50
Remedies Total
Shipping Cost
Total    USD  $