To order our products via FAX, please print this page, fill out the form and simply fax it to 604-847-3563

If you have any questions, you can call us Monday to Friday between 9:00 am & 5:00 pm (Pacific), TOLL FREE at 1 (877) 420-9211  and we will be happy to take your order over the phone.

Order Form		 All prices  are in US Dollars
   

Name:

Street:

City:

State/Province:

Country:

Zip/Postal Code:

   
Information  
   
E-mail Address:

Fax Number:

Phone Number:

All prices  are in US Dollars
Colvera  

Please rush me one bottle of Colvera

$59.95\bottle

Please rush me three bottles of Colvera

$149.95\combo

Aphrodisiacs/Impotence  
Powder of Love for Men (80 capsules)

Please rush me

$39.95\bottle
Powder of Love for Women (80 capsules)

Please rush me

$39.95\bottle
Combo Package (1 Men + 1 Women)

Please rush me

$69.95\combo
Virility Max for Men (80 capsules)

Please rush me

$47.95\bottle
Virility Max for Women (80 capsules)

Please rush me

$47.95\bottle
Combo Package (1 Men + 1 Women)

Please rush me

$79.95\combo

Blended Herbal Products
Energy Booster (80 capsules)

Please rush me

$29.95\bottle
Stress Aid (80 capsules)

Please rush me

$29.95\bottle

 

Shipping & Handling =

5.50
International orders-Outside of Canada and  the USA- please add $3.00 =

TOTAL IN US DOLLARS =

 
Credit Card Information

Card Type:

Card Number:

Name on Card:

Expiration Date:

  example  06/06
 

 

Botany Bay Botanicals
Suite 107
 12882, 85th, Ave Surrrey BC,
Canada, V3W 0K8
Toll Free  Order Line Call 1--877-420-9211
 Fax 604-847-3563
For Information or questions contact
webmaster@formulamaster.com