~ Nupharma Nutraceuticals Mail In Order Form ~
Date:____________ PRINT AND MAIL THIS ORDER FORM TO US AT :
Nupharma Nutraceuticals, 4045 Sheridan Ave. # 363, Miami Beach, Florida 33140
Please process my order for the products I have selected below ( please print clearly )
Name: __________________________________________________
Address: _______________________________________________Apt:#___________
Address: ________________________________________________
City: _________________________________ State: ______ Zip:______________
Your Telephone # _______________________________
Your Email Address: ________________________________________________________
* to notify you via email that your order has been shipped
BERES DROPS™ PRODUCTS:
Item # Product Name # Ordering X Cost Total Cost
5991011 ( 1 ) Bottle Beres Drops™ _______ X $17.95 $__________
5991013 ( 3 ) Bottles Beres Drops
 _______ X $45.95 $__________
5991016 ( 6 ) Bottles Beres Drops™ _______ X $79.95 $__________
5991012 (12) Bottles Beres Drops™ _______ X $149.95 $__________
ALKAPRO™ PRODUCTS:
Save $$$$ when you purchase (3 ) bottles
Each AlkaPro bottle comes with ( 4 ) FREE Litmus Paper Test Strips and
Color Chart for testing your pH via saliva or urine.
Item # Product Name # Ordering X Cost Total Cost
10001 ( 1 ) 1.3 oz ALKAPRO™ Bottle _______ X $17.95 $__________
10003 ( 3 ) 1.3 oz ALKAPRO™ Bottles _______ X $45.95 $__________
10006 ( 6 ) 1.3 oz ALKAPRO™ Bottles _______ X $79.95 $__________
10012 ( 12 ) 1.3 oz ALKAPRO™ Bottles _______ X $149.95 $__________
COMBO PAKS ~ ~ SPECIAL PRICING
10001BA (1) Each Beres Drops & AlkaPro _______ X $32.95 $__________
The AlkaPro bottle comes with (4) FREE Litmus strips to test your pH via saliva or urine

Oxegen AKG Super Sorb Formula™
Oxegen AKG 1 (1) 120 tablet bottle - 20 day supply
Suggested retail - $39.95		 _______ X $34.95 $__________
Oxegen AKG Super Sorb Formula™
Oxegen AKG 2 2 (2) 120 tablet bottles - 40 day supply
Suggested retail - $79.90		 _______ X $67.95 $__________
Oxegen AKG Super Sorb Formula™
Oxegen AKG 3 (3) 120 tablet bottle - 60 day supply
Suggested retail - $104.85		 _______ X $99.95 $__________

Oxegen BP Blood Pressure
Oxegen BP 1 (1) 90 tablet bottle - 45 day supply
Suggested retail - $39.95		 _______ X $34.95 $__________
Oxegen BP Blood Pressure
Oxegen BP 2 (2) 90 tablet bottles - 90 day supply
Suggested retail - $79.90		 _______ X $67.95 $__________
Oxegen BP Blood Pressure
Oxegen BP 3 (3) 90 tablet bottles - 135 day supply
Suggested retail - $104.85		 _______ X $99.95 $__________

Oxeslim DIET®
OxeSlim 1 (1) 90 tablet bottle - 30 day supply
Suggested retail - $39.95		 _______ X $29.95 $__________
OxeSlim 2 (2) 90 tablet bottles - 60 day supply
Suggested retail - $79.90		 _______ X $57.95 $__________
OxeSlim 3 (2) 90 tablet bottles - 90 day supply
Suggested retail - $104.85		 _______ X $79.95 $__________
OxeSlim Diet Shakes Chocolate (4) boxes
4 Shakes Per Box
16 Day supply
Suggested retail - $39.95		 _______ X $29.95 $__________
OxeSlim Diet Shake Chocolate (8) boxes
4 Shakes Per Box
32 Day supply
Suggested retail - $74.95		 _______ X $56.95 $__________
OxeSlim Diet Shakes Vanilla (4) boxes
4 Shakes Per Box
16 Day supply
Suggested retail - $39.95		 _______ X $29.95 $__________
OxeSlim Diet Shake Vanilla (8) boxes
4 Shakes Per Box
32 Day supply
Suggested retail - $74.95		 _______ X $56.95 $__________

Cholestsorb® with Garlic
Cholestsorb Garlic 1 (1) 60 tablet bottle - 20 day supply
Suggested retail - $29.95		 _______ X $28.95 $__________
Cholestsorb Garlic 2 (2) 60 tablet bottles - 40 day supply
Suggested retail - $59.90		 _______ X $54.95 $__________

Cholestsorb® with Niacin
Cholestsorb Niacin 1 (1) 60 tablet bottle - 20 day supply
Suggested retail - $29.95		 _______ X $28.95 $__________
000000 (2) 60 tablet bottles - 40 day supply
Suggested retail - $59.90		 _______ X $54.95 $__________

Prokak™ with NT Factors™
000000 (1) 30 pak bottle - 30 day supply
Suggested retail - $59.95		 _______ X $52.95 $__________
000000 (1) 60 pak bottle - 60 day supply
Suggested retail - $99.95		 _______ X $89.95 $__________

Cold and Flu Shoc®
One Box
20 Capules		 10 day supply
Suggested retail - $16.95		 _______ X $12.95 $__________
2 Boxes
40 Capules		 20 day supply
Suggested retail - $32.95		 _______ X $19.95 $__________
Four Boxes
80 Capules		 40 day supply
Suggested retail - $59.95		 _______ X $35.95 $__________
TOTAL ALL PRODUCTS: $____________
TOTAL DOLLAR AMOUNT OF ORDER - ( 1 ) $____________
PLUS ANY SHIPPING CHARGES:
- FREE Shipping/Handling Charges on Orders Over $50.00 Within U.S. ONLY -
Add $5.95 shipping if order is less than $50.00
If your order is shipped overseas-shipping/handling
Or shipped - -See Chart Below - and add shipping ( 2 )
* Minimum order is (3) bottles for overseas shipments		 $____________
Total Amount - Add All Columns (1 ) and ( 2 ) Above $____________

Personal checks will delay shipment of order for 10 business days
Please send certified bank cashiers check or money to expedite your order.
Free Shipping is limited to shipments within the U.S. and orders over $50.00

I would also like to subcribe to your monthly internet newsletter,
Healthy Living ____Please Place a Checkmark
Product must be shipped to same address as your credit card billing.
Please Charge My Credit Card, My Credit Card Number Is: Type: Visa___MC___Discover___American Express___ ( please check one )
Credit Card #: ___________________________________________
_______(3) digit # at end of number on reverse 		Expiration Date: ______/______
Your Signature:__________________________________________ Date:__________
Orders cannot be processed without your
Telephone Number, Email Address and Signature

FREE SHIPPING IS LIMITED TO ORDERS OVER $50.00 AND SHIPPED WITHIN U.S.
SHIPPING CHARGES APPLY TO ORDERS SHIPPED OVERSEAS
For details on * FREE SHIPPING WITHIN U.S. please click HERE

SHIPPING CHARGES TO OTHER DESTINATIONS OUTSIDE U.S.
If your shipment is shipped outside the U.S.- These shipping charges will apply.
We can only ship (6) bottles shipments to these countries,
Canada, England, Turkey.
See Below For Details.
U.S. Global Priority
CANADA
(6) bottle shipments only
All Products
$24.95
U.S. Global Priority		 ENGLAND
(6) bottle shipments only
All Products
Except AlkaPro
$39.95
AlkaPro
$29.95
U.S. Global Priority		 TURKEY
(6) bottle shipments only
All Products
Except AlkaPro
$39.95
AlkaPro
$29.95
U.S. Global Priority
CANADA
U.S. Global Priority
5 Busines Days
SEE ABOVE		 Europe,
South America, Africa
Air Mail 5-7 Business Days
$52.95 per order
up to 12 products
Minimum Order
(3) bottles-Any Product
up to 24 products or
(2) 12 paks -$69.95
up to 36 products or
(3) 12 paks -$119.95
up to 48 products or
(4) 12 paks -$149.95 		Pacific and Far East, Australia
U.S. Global Priority
7-10 Business Days
$59.95 per order
up to 12 products
Minimum Order
(3) bottles-Any Product
up to 24 products or
(2) 12 paks -$79.95
up to 36 products or
(3) 12 paks -$129.95
up to 48 products or
(4) 12 paks -$159.95
Updated February 6, 2008