Want to pay by Check? Just Print and Mail this Form!

Check Order Form

Send a Check or Money order To:

Aquarius Internet Inc.
Check Order Dept 14
11084 Blackhawk Blvd Davie, FL 33328

I would like to Order:
1 Bottle Thermadrol at $29.97 Plus $4.99 Shipping Total $34.96

2 Bottles Thermadrol at $49.97 Plus $4.99 Shipping Total $54.96

3 Bottles Thermadrol for $74.91 Plus $4.99 Shipping Total $79.90

Name______________________________________
Ship Address_____________________________________
Ship Address 2___________________________________
City__________________ State_________Zip_________
Phone______-________-________