Printable Order Form - Customer Order Information

Complete order information below, print form and send with your check, cashiers check or money order for the total amount including shipping cost to:

Bleach Pro Whitening
18504 NE 32nd Cir.
Vancouver, WA 98682

SHIPPING INFORMATION
First Name Last Name
Address
 
City State
Province or other

Country Zip/Postal Code
Daytime Phone Email Address
ENTER QTY




ENTER TOTAL AMOUNT        

Please enter the total amount based on quantity times the product price plus shipping cost. Then print this form and mail to Bleach Pro Products at the address above along with personal check, cashiers check or money order. Payments received that do not equal the total order amount are subject to return. To order different items, you will need to repeat the form completion steps, but only a single shipping charge will apply to the multiple items. Once mailed form(s) are received and payment verified, orders usually ship within 1-2 business days. Please allow sufficient time for delivery. Thank you for your order!

INTERNATIONAL CUSTOMERS: NO PERSONAL CHECKS ACCEPTED. MONEY ORDERS ONLY MADE OUT IN U.S. DOLLAR AMOUNT OF ORDER.