Order Form

QTY	Product Description	Size	Price ea.
	Neova® Products
	Neova Eye Therapy	0.5 oz	$42.40
	Neova Night Therapy	2 oz	$68.90
	Neova Day Therapy	2 oz	$68.90
	Neova Antioxidant Serum	1 oz	$90.10
	SkinMedica (TNS)
	Uplifting Eye Serum	0.5 oz	$37.10
	TNS Recovery Complex	0.5 oz	$132.50
	ProCyte Sun Protection
	Ti-Silc Sheer SPF 45	4 oz	$26.50
	Ti-Silc® Untinted SPF 45	4 oz	$26.50
	Z-Silc^TM Sun block SPF 30	3.5 oz	$31.80

Calculate and Enter Total Amount of Purchased Items Here: Subtotal: $

US ORDERS: Shipping charges are: $6.95 for 1 item. Add $1.00 per additional item. Orders totaling $90.00 or more get free shipping.

INTERNATIONAL ORDERS:
Shipping charges: $30.00 for 1 item.
Add $5.00 per additional item.

ALL ORDERS WILL BE SHIPPED WITHIN 48 HOURS OF RECEIPT OF ORDER. FOR SAME DAY SHIPPING ADD $5.00 EXPRESS FEE.

	Shipping Charges: $
	Total Amount Due: $

For customers protection all orders must be shipped to billing address of credit card used for purchase.
First Name:	Last Name:
Address:
City:		Zip:
Phone:	Fax:
Email:

Credit Card Information
Card Number:		Card Type:
Cardholders Name:		Exp. Date
Card Identification Number: (CVC)		Help with CVC number?

Additional Comments or Instructions:

PLEASE NOTE: NO REFUNDS WILL BE ISSUED.
Due to hygienic reasons we can't accept returns, therefore, if you have any questions on any product please contact us prior to ordering.
You may reach us at 561-620-6262 or via e-mail: info@niakessler.com .
We try to return all phone calls and e mails within 24 hours.