Mail to:
Cover My Back
P.O. Box 1403
Sandy, UT 84091
Fax orders to:
(801) 467-8364

SHIP TO:
Name
Address
City ST ZIP
Phone E-mail
The Lotion Applicator  
QTY
DESCRIPTION
PRICE
TOTAL
       
   Lotion Applicator - Color: Forest Green
$12.50
  
   Lotion Applicator - Color: Sage Green
$12.50
  
   Lotion Applicator - Color: Navy Blue
$12.50
  
   Lotion Applicator - Color: Windsor Blue
$12.50
  
   Lotion Applicator - Color: Cream
$12.50
  
   Lotion Applicator - Color: Plum
 $12.50
  
 

 

   
   Pre-arranged Bulk Order - Please add Total, S/H and Tax if required.    

Shipping & Handling Charges:
1 item add $2.49. 2-4 items add $4.99, 5-8 items add $9.99, 9-16 items add $16.99 S/H. For bulk orders for S/H

SUBTOTAL $
Shipping & Handling $

 ( UT State residents add 6.6% sales Tax )

UT Add 6.6% Tax $
 This page was updated in:
  http://www.covermyback.com		 TOTAL DUE $
 

PAYMENT METHOD: - Please make payments to Cover My Back


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Amt. enclosed: $____________