Print out this form using your browser, then fill in the information needed
to place your order. Fax the completed form to us at (808)356-0166.
We will process it right away and send your order to you within 24 hours
(excluding weekends).
Military Post Office*_________________________________________________________
Military State*____________________________________________________________
Zip Code*_______________________________________________________________
Contact Phone Number (if available) ___________________________________________
SHIPPING INFORMATION:
We only offer US First Class Mail shipping at this time. Delivery times
vary. The cost for U.S. First Class Mail is $6.00 for up to 12 oz. All
orders are insured.
PAYMENT INFORMATION:
You can pay for your order with any major credit card or by check (drawn
on a US Bank).
CREDIT CARD PAYMENTS
Credit Card Type: (fill in one circle)
Visa
MasterCard
American Express
Discover
You can pay for your order with funds from your checking account. Just
enter the information "EXACTLY" as it appears on your check into the boxes
below. We will "cut a check" using the information you provide
and send you a copy of it with your order.
Saves time! Saves money (no stamp)! No need to write and mail us your
check.
If you have trouble locating the information that is needed for the form
below, please take a look at the sample check below this form for some
additional help.
PLEASE NOTE: All checks returned due to Non-Sufficient Funds (NSF)
will be charged a $25.00 NSF Fee! Also, please void the check that you
use so that you do not use the same check number twice!
Your name
Your address
City
State
Zip code
Check #
ABA #
The ABA # is located
close to your check #
and looks like this 01-5678/1234
Pay To The Order Of NATURE
DOC
Your Bank's Name
Your Bank's Address (May omit if not on check.)
Your Bank's City
Your Bank's State
Your Bank's Zip Code
Enter the numbers from the bottom of your check in the 2 boxes
below:
Routing # Account
#
The sample check below provides some additional help for locating the information
needed in the above form.
USE THE PRINT OPTION ON YOUR BROWSER TO PRINT
A COPY OF THIS FORM. FILL IT IN AND FAX THE COMPLETED FORM TO US AT (808)356-0166.
Return to ABOUT
SCARS & KELOIDSorder
page in English for the US Military.