Thank you for ordering the Baba Belt™

Please print and send this form along with you payment

E-mail Address:  
Shipping Name *  
Shipping street address *  
Apt. #  
City *  
State *  
Zip code *  
Color * (Please circle one) Pink Blue Yellow
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Quantity (Circle one) 1   2   3   4   5   6   7   8   9   10   11or more (please contact us)
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Please calculate your order below

$9.99 ea.  
$3 f/shipping, $0.50 shipping each additional  
Total ------------------------>
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Send check or money order to:

Baba Belt

P.O. Box 2985

Carson City, NV 89702-2985

Please allow up to 10 days for delivery

 

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