FAX ORDER FORM &
Order Information
TOLL FREE:1-888-4VABIEN OR 1-888-4822436

FAX:1-787-7327004

E-MAIL:SALES@VABIENUSA.COM
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*Please choose among these 3 options: fax order form or call us with you order or email us all info fields per form provided
Product Name Size Color Quantity Cost
         
         
         
Sub Total: $
Standard shipping is via USPS Priority Mail, Next Day and Two Day air are shipped via UPS.
Cost of Order $0-$75.00 $75.00 +
Standard Shipping $8.00 Free
Next Day Air (not available to PO. Box addresses) $40.00
Two Day Air (not available to PO. Box addresses) $25.00
International $40.00
For orders more than 2 pcs
Ship Complete?		 Yes No
Shipping Charge: $
Grand Total: $
 
-Billing Information-
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-Shipping Address-
Please fill out if different from Billing Address above.
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