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Printable Order Form
Print out this page, fill out the form below and mail or fax it back to us.
ENTERTAINER'S SECRET® THROAT RELIEF
The Solution for Dry Throat and Hoarse Voice
Fax Back Form - Fax to: 317-846-1676 -or-
Mail Back Form - Mail to: KLI CORP, 1119 Third Ave SW, Carmel, IN 46032 -or-
Call Toll Free: 1-800-308-7452
Quantity Desired
(___) Two bottles - $17.00 (Indiana residents add $1.19 Indiana Sales Tax)
- or -
(___) Six bottles - $43.00 (Indiana residents add $3.01 Indiana Sales Tax)
Billing & Shipping Information
Name: _______________________________________________
Address: _____________________________________________
_____________________________________________________
City: ________________________________________________
State: ______ ZIP_________________ Country:_____________
E-Mail: _________________________ Phone: __________________
Shipment Method ________________________________
Payment & Payment Method
Indiana Sales Tax (7%): $________________ (applicable to Indiana residents only)
Total cost: $________________
(___) Check enclosed (Make payable to KLI Corp)
(___) Charge to: (___) Visa (___) Master Card (___) Discover (___) American Express
Credit Card No: _______-________-_______-________ Expiration Date: Mo:_____ Year ____
Please help us by answering the following questions
Profession: _____________________________________
Gender: (___) Male (___) Female
Age: (___) 30 or under, (___) 31-50, (___) 51-70 (___) 70+
Where did you learn about Entertainer's Secret? _____________________________________
THANK YOU VERY MUCH!
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