Active 8 Better Health Better Life Diet Plan Mail Order Form

send to:

Active 8, 3838 NW 36th St, Ste. 104, Oklahoma City, Oklahoma 73112

Or Call 1-800-465-4411


                             Please Print

Name*:_________________________________________________________________

Address*:_______________________________________________________________

City*:_________________________________ State*:______ Zip*:________________

Phone:______________________Email:______________________________________ Credit Card# (optional):__________________________exp.date:____________   

*Required Field

Quantity

Price Each

Total

Active 8 BH BL Diet Plan with  Supplements and Drinks:

30 Chocolate Protein Drinks    ____________  $159.95 ____________
30 Vanilla Protein Drinks   ____________  $159.95 ____________
30 Strawberry Protein Drinks   ____________  $159.95 ____________
10 ea. Choc/Van/Straw Protein Drinks   ____________  $159.95 ____________
15 ea. Chocolate/Vanilla Protein Drinks   ____________  $159.95 ____________
15 ea. Chocolate/Strawberry Protein Drinks   ____________ $159.95 ____________
15 ea. Vanilla/Strawberry Protein Drinks   ____________ $159.95 ____________
Supplements Only:
Supplement  #1   ____________ $34.95 ____________
Supplement  #2   ____________ $29.95 ____________
Supplement  #3   ____________  $29.95 ____________
Protein Drinks Only:
30 Chocolate   ____________

 $69.95

 ___________

30 Vanilla    ____________  $69.95 ___________
30 Strawberry    ____________  $69.95 ___________
15 ea. Chocolate/Vanilla   ____________  $69.95 ___________
15 ea. Chocolate/Strawberry   ____________  $69.95 ___________
15 ea. Vanilla/Strawberry   ____________  $69.95 ___________
10 ea. Choc/Van/Straw   ____________  $69.95 ___________

SUBTOTAL

___________
Shipping & Handling For Orders Totaling:

 

  Less than $40 ADD:

 $4.95 ____________

$40.01 - $65 ADD:

 $5.95 ____________

$65.01 - $100 ADD:

 $7.95 ____________

                                                                                over $100 ADD:

$11.95 ____________

OK residents only-please add 8.375%

Sales Tax

____________
   

TOTAL

 
 

Please make checks payable to Active 8.