Sportswell Limited Mail or FAX Order Page

  Simply Print and Mail or FAX Payment To:
  Sportswell Limited
  47 Rutherford Drive,
  Waikanae 6010
  Phone: 0064 4 293 2597
  Payment payable to "Sportswell Limited"
Contact Information  
First Name: _________________________________________________
Last Name: _________________________________________________
Phone Number: _________________________________________________
Fax Number: _________________________________________________
Email: _________________________________________________
Delivery Address _________________________________________________
Payment Details If you are paying by Credit Card, please fill in the required information below.
Name as on Credit Card _________________________________________________
CC# Street Address _________________________________________________
CC# City _________________________________________________
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CC# State _________________________________________________
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Description Price $US Number Total Price
1 bottle " Velvita" plus postage 33.95    
2 bottles "Velvita" plus posatge 63.95    
4 bottles "Velvita" - 1 free plus postage 105.95    
1 spray bottle "Velvita" IGF-1 43.95    
Total Price in US$ (add $9.95 for postage) 9.95    

Add air postage of $9.95 to all orders

Multiply US$ by NZ$ Exchange Rate to convert to NZ $ if sending a personal check, bank check or money order.


Shipping by New Zealand Post Air International - 4 to 12 days delivery.

Credit Card Details

Please circle the credit card type: VISA, MASTERCARD

Credit Card Number:_____________________________

Credit Card Expiration Date:_______________________

Signature of CC holder:___________________________