PLEASE PRINT OUT & MAIL THIS FORM TO ORDER
THIS ORDER FORM MUST BE COMPLETELY FILLED OUT & MAILED WITH YOUR CHECK
OR ORDERS WILL NOT BE FILLED. SORRY, WE CANNOT ACCEPT CREDIT CARDS
Name____________________________________________Phone: ( )_________________________
Email Address: (Must Provide)_________________________________________________________
Address______________________________________________________Suite/Apt #_____________
City____________________________________State___________Zip_______________
Please make your check out to HRI, LLC.
SHIPPING FEES: * $6.00 | ** $20.00
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** ADD $15.00 per each additional Integrator adjusting instrument.
Foreign prices & shipping fees are higher
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HOLDER RESEARCH INSTITUTE (HRI, LLC.)
3303 Flamingo Drive, Miami Beach, Florida 33140
800-490-7714
PLEASE PRINT OUT & MAIL THIS FORM TO ORDER