Planet Chiropractic Temporary Tattoos

Chiropractic Superstar For the Planet Peace Love Chiropractic Chiropractic Brightens Up My Day!
"Superstar" "For the Planet" "Peace, Love" "Sunshine"

Please Print and Fax this order form to: 1 310 301-4438
You can also reach us by mail at:
Planet Chiropractic -- 2509 Ocean Ave., Venice, CA 90291

Quantity of "Superstar"  ___________ @ $25.00 per pack
Quantity of "For the Planet" ___________ @ $25.00 per pack
Quantity of "Peace, Love" ___________ @ $25.00 per pack
Quantity of "Sunshine" ___________ @ $25.00 per pack
(Tattoos are sold in packs of 100)

Shipping per order

______$4.50  (all prices in US funds)

Total Due

___________

* We accept checks drawn on US banks and International Postal Money Orders in US dollars.

Ship to: _____________________________________
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Phone: _____________________________________
Bill to: _____________________________________ (if different from shipping)
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VISA _____  MasterCard ______  AMEX _____  DISCOVER ______
Credit Card #_____________________________________ Expire Date __________
Signature ______________________________ Today's Date ___________
Check Enclosed __________ (Please make checks payable to: Planet Chiropractic)
Your email address ___________________________ (so we can notify you via email)

Thank You For Your Order!