FAX - order

Please send me the following number of boxes HORMOTEX^TM pills:

1 (one) box x 24 pills at EUR 12,00 + EUR 5,50 = EUR 17,50

3 (three) boxes x 24 pills at EUR 35,00 + EUR 5,50 = EUR 40,50

10 (ten) boxes x 24 pills at EUR 85,00 + EUR 5,50 = EUR 90,50

Postage will be sent immediately by registered mail. EUR 5,50 are shipping charges.

If you want more than 10 boxes please inquire!

Mailing Address:

Payment in advance required:

• by PayPal (send to: neomed-robin@t-online.de)
• Western Union or
• SEPA-Transfer to IBAN: DE13230501010001014505 BIC: NOLADE21SPL.

Place/Date of order:

Signature:

Client confirms that he has full age.

Postage will be confidential in neutral parcels / envelopes mentioning sender only.

Neomed Pharma GmbH
Moltkestr. 38
23564 Lübeck
Germany
Tel. ++49 451 795024
Fax ++49 451 792895
e-mail: neomed-robin@t-online.de