To order, please print out, complete, and fax or mail the form below to:
Bright Lines, Inc.
P.O. Box 806
Mt. Laurel, NJ 08054
Fax: (856) 482-0904
To make your payment:
Please call Bill Kelley toll free at: 1-877-33-SMILE (1-877-337-6453) with your credit card information or mail us a check or money order made payable to the above address.
Save up to 45% off the regular retail price of $19.95
Name:
Address:
City:
State:
Zip:
Telephone:
Fax Number:
Email Address:
Special Internet Pricing
Shipping Charges
1 to 3 Jars: $16.00 Per Jar
$4.50 for 1 Jar & Add $0.50 Per Additional Jar
4 to 11 Jars: $15.00 Per Jar
$6.00 for 4 Jars, Add $0.50 Per Additional Jar
2 Cases (12 Jars Per Case): $13.00 Per Jar
$8.50-$10.50-$11.50 Per Case (see below)
Save 45% 3 Cases (12 Jars Per Case): $11.00 Per Jar
$8.50-$10.50-$11.50 Per Case (see below)
More Than 3 Cases (12 Jars Per Case)
Call Us!
Quote Refill Bags: $7.50 Each
$2.50
Order Individual Jars Here:
TITLE
QUANTITY
COST
PER JAR
TOTAL COST
Friend
$
Mom
$
Bible
$
Order Individual Cases Here: (12 Jars Per Case)
TITLE
QUANTITY
COST
PER JAR
TOTAL COST
Friend
$
Mom
$
Bible
$
Order Individual Quote Refill Bags Here:
TITLE
QUANTITY
COST
PER JAR
TOTAL COST
Friend
$
Mom
$
Bible
$
Subtotal:
$
In New Jersey add 6% Sales Tax:
$
Shipping & Handling: (Please note: On Case orders - Mountain Time Zone add $2.00/case, Pacific Time Zone add $3.00/case)
