ACADEMY SKIN CARE PRODUCTS             RETAIL ORDER FORM
1. Print this form on your printer.
2. Fill in your order.
3. Mail or Fax (for credit card orders) it back to us with your payment.

4.PayPal - return back to your product information and click on the ADD TO CART BUTTON

PRODUCT SIZE(oz) PRICE(US $) QTY TOTAL
GLYCOLIC CREME-10(pH 1.7%) 2.0 50.00    
HYDROLIGHT-10(pH 1.7%) 2.0 55.00    
ACNE CONTROL -10(pH 1.7%) 4.0 30.00    
COMPATIBLE MOISTURIZER 4.0 30.00    
BODY CREME 8.0 30.00    
COMPATIBLE CLEANSER 4.0 25.00    
MOISTURIZING SUN SCREEN WITH CoQ10-SPF15 2.0 30.00    
FACIAL SCRUB 4.0 25.00    
* SPECIALTY KITS WITH FREE TOTEBAG *
REJUVENATION KIT: Cleanser, Creme, Moisturizer, Brochure, Patient Video   110.00    
BLEMISH CONTROL KIT: Scrub, Dermabuff, Acne Control, Brochure, Patient Video   65.00    
LIGHTENING KIT: Hydrolight Plus, Cleanser, Sunscreen, Brochure, Patient Video   105.00    

SKIN CARE TOTAL

  

7% SALES TAX, NJ ONLY

 

SHIPPING & HANDLING (click here FOR RATE)

 

TOTAL

  
Payment Included (check one):   Do Not Send Cash.
O Check (payable to CAC)
O Credit Card            O MC   O VISA   O AMEX

Name on Card:_____________________________

Number:_____________________________  Exp. Date:____________

Signature:_____________________________
Mailing Address:
Name:      __________________
Address:  __________________
          _____________________
City:        _______________
State:       ________ Zip:_________
Country:  ____________		 *Email Order to:
candylangan@aol.com

*Mail Order to:
CAC
1050 West Main Street
Freehold, NJ
07728

*Fax order to:
(732) 780-2346

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