Please Phone, Mail or Fax to the Number below.

Quantity for each Style and Size
Size Pant/Slack Size #665 Preg Support
(lite'N'cool)		 #675 Preg Support
(Cradle 'N' Lace)		 #685 TummyTuck
(Back_to_Normal) 		 Qty   Price
Each 		  Total 
J  1-3            
P 4-7            
S 8-10            
M 12-13            
L 14-16            
XL 18-20            
XX 22-24            
X3 26-28            
X4 30-32            
X5 34-36            
X6 38-40            
Figure The Amount Due
Size Price X

Qty.

 = Total
*#5180 - Delicat Cold Water Wash #5180- Delicat is safe for bras, lingerie, nylons, baby cloths and delicate fabrics, yet strong enough to remove stains, body oils and odors. This formula will lengthen the life of all fine apparel and is the only product recommended for washing our custom fitted bras and support garments. The elastic will last longer. It is all natural, organic environmentally safe, concentrated and economical to use.

 

 

 

 

 

 
J  $61.00

X


=
P  $65.00 X
=
S  $66.00 X
=
M  $73.00 X
=
L  $75.00 X
=
XL  $77.00 X
=
XX  $78.00 X
=
X3  $79.00 X
=
X4  $81.00 X
=
X5  $81.00 X
=
X6  $81.00 X
=
5180* $13.00 X
=
Subtotal $
Add S&H $

Add $10 for 2nd day UPS

 $

Local Sales Tax

 $

Grand Total

 $

Customer Information

Name:_________________________________________
______________________________________________
Address:_______________________________________
______________________________________________
City:___________________________________________
State:________________Zip:_______________________
Phone:_________________________________________
Email:__________________________________________

Payment Type: (Do NOT make payable to Jeunique)
[ ] Check or M.O.                    Checks &  M.O.
[ ] Debit Card                              payable to
[ ] Master Card                         CONSULTANT
[ ] VISA                                  Total Amount Due
[ ] Discover                             $______________
[ ] Am. Express

Name on Card:
_______________________________________________
_______________________________________________
Card No:________________________________________
Exp. Date:________________________________________
Signature:
________________________________________________
[ ] Yes, I  would like to be sized for a custom fitted bra (doubles
     as maternity/nursing bra

Phone order to:                (413) 323-4453
Cell Phone order to:        (413) 244-4870
Call for Fax number

Mail your order to:
Gail Bogdanovich
1 ROCKRIMMON ST
BELCHERTOWN MA 01007

E-Mail Gail: gailbra@aol.com