Fax order form

To order by fax, please print out this page, complete and fax to our offices. If you wish to pay via internet transfer please click here for bank details.

Our fax number in Pretoria, 012. 361 0061

PLEASE NOTE – We charge R 35.00 for delivery anywhere in South Africa and our minimum order quantity is R 150.00 per order.

Please read more on South African deliveries...

To return to our products page, click here, and to go to our home page, click here.

Name and surname
Credit card type Visa / MasterCard / Amex / Diners (Circle the type)
Card number  
CCV number (3 digit number on the back of your card on the signature strip)

 

Expiry date Month (............) Year (............)
E-mail address  
Telephone number  
Full street or postal address
(including State, Province and postal/ZIP code.)
line 1
line 2
line 3
Signature as on card:

.....................................

Province/State:
Postal / ZIP code:
(Postal code is also used for courier parcels, as courier companies use the code to sort their parcels)
Description

Quantity

Total

REJUVENATING RANGE
Rejuvenating Face Wash    
Rejuvenating Face Wash REFILL    
Rejuvenating Toner
Rejuvenating Toner REFILL
Rejuvenating Serum     
Rejuvenating Day Cream    
Rejuvenating Night Cream    
Rejuvenating Eye Cream    
Instant Eye Lift
Rejuvenating Neck Cream    
Rejuvenating Mask    
Exfoliating Face Scrub    
Purifying Mask    
PROBLEM SKIN RANGE
Problem Skin Wash    
Clarifying Toner    
Problem Skin Day Gel    
Problem Skin Night Lotion    
Spot Treatment Cream    
Problem Skin Mask    
Problem Skin Deep Enzyme Cleanse    
BODY CARE RANGE
Cellumend Cellulite Cream    
Courier fees 35.00

Total SA R