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Miscellaneous
1. Fill out this form
2. Send your check to :
Marie Allizon
1063 National Press Bldg. N.W.
Washington DC 20045
Name
Address
City, State
Zip Code
Email address
Tel. Number
Miscellaneous
Size
Quantity
US$
unit price
Total US$
St John's Wort
1 oz
1/2 oz
1/3 oz
4 ml
2 ml
0
1
2
3
4
5
6
7
8
9
10
Calendula
1 oz
1/2 oz
1/3 oz
1 dram
2 ml
0
1
2
3
4
5
6
7
8
9
10
Drinks
1 oz
1/2 oz
1/3 oz
0
1
2
3
4
5
6
7
8
9
10
Arnica
1/3 oz
4 ml
2 ml
0
1
2
3
4
5
6
7
8
9
10
Bath Oils. Mikael's "Release"
1 oz
1/2 oz
1/3 oz
1 dram
2 ml
0
1
2
3
4
5
6
7
8
9
10
Rose Water 2oz Damas
2 oz
0
1
2
3
4
5
6
7
8
9
10
SHEA butter
50 ml RP 04
25 ml RP 03
0
1
2
3
4
5
6
7
8
9
10
SHEA butter with rose
50 ml RP 04
25 ml RP 03
0
1
2
3
4
5
6
7
8
9
10
Small car diffuser
each
0
1
2
3
4
5
6
7
8
9
10
Small Diffuser (electric)
each
0
1
2
3
4
5
6
7
8
9
10
Large Diffuser with nebulizer
each
0
1
2
3
4
5
6
7
8
9
10
Shipping charges:
TOTAL
: