Exadrine Capsules Order FormMake checks payable to: NuStar Labs10810 N. Tatum #102-301 Phoenix, AZ 85028 | |
| Name: | |
| Shipping Address: | |
| Phone: | |
| E-Mail: | |
___ 1 Bottle $69.95 ___ 2 Bottles $119.90 ___ 3 Bottles $169.85 ___ 4 Bottles $219.80 | |
| ___ SHIPPING - Add $6.95 (US Orders), $12.95 (International) | |
| ___ RUSH Delivery - Add $5.00 | |
| Total Amount Enclosed $________________ | |
| Let us know how you heard about us _________________________________________ | |