Order Form

Name: ___________________________
Shipping Address:
Address: ___________________________
City, State, ZIP ___________________________
Phone Number: ___________________________
E-mail Address: ___________________________

Billing Address:  (If different from shipping address)
Name: ___________________________
Address: ___________________________
City, State, ZIP ___________________________

Stock Number Description Quantity Unit Price Total Price
         
         
         
         
         
         
         
         
         
Sub Total:  
If Sub Total is $40 or more, check this box if you would like free NSP membership:   
Shipping/Handling ($7.50 for orders under $100, $11.00 for orders of $100 or more):  
Add your sales tax:
(Most states are collecting now--if you have a question whether your state does, please call us. If you send us sales tax and your state does not collect it, we will refund you.)		  
Total Price:  

Payment Information: 
___ Credit Card      ___ Personal Check      ___ Money Order

Credit Card Number:______________________________________________ Exp. Date: _______

 Please mail this form to: 
Healthy Sunshine, Inc.
506 Ivy Lake Road, Morrison, TN 37357
Fax orders to:  931-450-1506

Please make any checks payable to Healthy Sunshine, Inc.
If you have questions, call us toll free at 1-888-523-1727.