Fax this form as well as the Deposit slip or proof of Internet Transfer
To: (021) 790-8301

Organo-Slim
Bank Deposit or Bank Transfer

Phone No's: (021) 790-4548
(021) 790-3763
(021) 790-9897
(021) 790-7508

ORDERED BY
DATE: ___  /___ / 20___
Name: _____________________________
Postal Address: _____________________
__________________________________
__________________________________ Postal Code: ________
Phone Work: (_______)_______________
Phone Home: (_______)_______________
Cell:     ____________________________
Where did you hear about us? __________ (Referal; Re-Order or Magazine name)
Provide the QTY and Total for chosen items
QTY
COST
TOTAL
1) Organo-Slim - Indicate how many sets you want
1 set = 2 Months supply - 1 Months supply for FREE!!
R234
2) Be-Trim Citri-Magic Metaboliser - 1 Months supply
The real Fat Burner!
R202
3) Be-trim Metabo Boost - 1 Months supply
Super Fast Metabolism
R202
4) Be-Trim Fat-Stop & Carbo-Stop - 1 bottle of each
Lose Weight the easy way!!
R444
5) K2 - Anti-Cellulite Shrink Kit
Be-Trim Cellu-Magic; Shrink Cream; Shrink Wrap Cream & Wrap
R490
Organo-Slim Special! - 3 Sets = 7 bottles!!
7 Months Supply for only 3 Months Cost!!
R720
Organo-Slim Intensive Weight Loss Program (1, 2, 3, 4, 5)
If you are serious!! If you want to lose FAST!! *Note over 1kg.
R1 572
Insurance Optional. 2% of value of parcel including postage.  
Delivery - choose option*
TOTAL
Signature

______________
* Door deliveries - SA only - allow 2 to 3 working days. R105
Nearest post office - SA only - next working day. R85 per kilo
Rest of Africa - goes to home address via registered mail. R85 per kilo. For countries outside Africa – please phone or e-mail us for a quotation
Direct deposit or Internet Transfer into Bank Account
Please Deposit Value of Products + Insurance + Delivery Cost
FIRST NATIONAL BANK - Hout Bay - Branch Code: 204 009
Account Holder: Organo-Slim.
Cash Deposit Only
Account No.: 7414-1744-273
Acc Type: Bus 32 Day Interest Plus
For ex-SA customers - also give the Swift Transfer Code: FIRNZAJJ

Note: Cash only - unfortunately we do not accept cheques
Electronic/Internet Transfer Only
Account No.: 6205-8807-797
Acc Type: Bus Call Account

Note: If you transfer money or do an Internet payment from another bank there could be delays of 3 or more working days before it shows on our statement. Do not deposit Cash into this account!!