ORDERING THE ICE WAND BY INVOICE

BILLING ADDRESS:
Input Fields in Red below are required entries!

First and Last Name:
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Email Address:
Address:
Address:
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Zip Code:
Auto Ship Replacement:	Yes: No:
IceoMatrix offers a 100% money back guarantee for customers on the auto replacement program if you are not satisfied with the results of the ice wand. The "Auto Ship Replacement" item above allows you to receive replacement "Ice Wands" on regular 90 day intervals (recommended). Your credit card will be automatically billed when shipment is performed. If you do not wish to receive replacements automatically, be sure to select "No" in the field above.
PRICING: The price of the Ice Wand is $49.95. Discounts are available for select franchises and Coca Cola national accounts. To receive the Coca Cola preferred customer discount, you must enter your Coca Cola account number or the name of your Coca Cola representative. Discounts are automatically applied when you provide the information below.
Francise Affiliation:
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SHIPPING INFORMATION:

Shipping and Handling: (prices are per shipping location)	Quantity Shipping & Handling 1 2 3 4 5 6 or more $4.00/unit $3.00/unit $2.33/unit $2.00/unit $1.80/unit $1.66/unit
Orders will ship within 2 days.

ORDER INFORMATION:

Product	Unit Price	Total to be Invoiced
IceoMatrix Ice Wand™
	Total Units Ordered:
For orders being placed from outside the U.S, please contact us via our Contact page.

SHIPPING ADDRESS 1:

Quantity to be Shipped to This Address:
Select this check box if "Shipping Address 1" is the same as the billing address.
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SHIPPING ADDRESS 2:

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SHIPPING ADDRESS 3:

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SHIPPING ADDRESS 4:

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SHIPPING ADDRESS 5:

Quantity to be Shipped to This Address:
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