Order Confirmation Form

EverCLR International Corporation

THIS IS A SECURED SERVER PAGE. YOUR DATA IS SAFELY ENCRYPTED AND IS SAFE FROM UNAUTHORIZED ACCESS.

FIRST TIME BUYERS ONLY: Please request (2) bottles of EVERCLR at $49.95 per, for a total of $99.90. You will receive a third bottle FREE! Type 'Free Introductory Offer' in the message box at the end of the form.

We offer a 100% money back guarantee!

Billing Information
*Full Name:
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Please check this box if you wish the shopping cart to remember your personal information for future purchases.

Ship To Information
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Credit Card Payment Information
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Product Order Information

Quantity	Description	Total
	EverCLR (240mg, 90 caps) $49.95	$
Product Total		$
%		$
Shipping Method		$
Grand Total		$

Please note: SHIPPING & HANDLING - U.S.A.: Add $7.50 for Priority Shipping & Handling; ALL OTHER COUNTRIES: Add $12.00 for International Priority Shipping & Handling.

Comments/Special Delivery Information

I authorize EverCLR International Corporation to charge me for the above total.
I further affirm that the name and personal information provided on this form are true and correct.

I further declare that I have read, understand and accept EverCLR International Corporation's business terms as published on the web site.

By pressing the ORDER button below, I agree to pay EverCLR International Corporation.

ORDER PROCESSING MAY TAKE UP TO 90 SECONDS.
TO PREVENT ERRORS, PLEASE CLICK THE ORDER BUTTON ONLY ONCE.

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