AquaBells® - Printable Order Form

Complete all the fields below to enjoy staying in shape with your new AquaBells Travel Weights soon.

To order by Next Day, 2nd Day, or 3rd Day UPS please call our toll free number 1-800-987-6892 to ensure ontime delivery.

Please enter your Billing contact information below:

First Name:
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Please enter your Shipping contact information below:
Shipping Information is the same as billing
First Name:
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Select the product(s) of your choice:	Products Price Shipping & Hanlding Quantity Dumbbells - AB2 $59.95 $ 9.95 - USA/Canada $24.95 - International Ankle Weights - AW2 $29.95 $ 9.95 - USA/Canada $24.95 - International Combo Set - CS2 $79.95 $ 9.95 - USA/Canada $24.95 - International Cold Pack - CP $16.95 $ 9.95 - USA/Canada $24.95 - International Subtotal California residents add 7.25% sales tax Shipping and Handling Total Order Amount
Credit Card Information:	Credit Card Type Visa Master Card American Express Credit Card Number (example: 1234567891234567) 16 digits total Expiration Date (example: 0402)

Thank you for your order!

Order by FAX 1 ) Print out this Order Form 2) Fill out this form completely 3) Fax orders to: 509-325-4266

Order by MAIL 1) Print out this Order Form 2) Fill out this form completely 3) Mail in with check to: AquaBells Travel Weights 174 South Coeur d' Alene Street, H101, Spokane, WA 99201