PRODUCTS & SUPPLIES ORDER FORM 2019


Print Order Form

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
** ADD $15.00 per each additional Integrator adjusting instrument.
Foreign prices & shipping fees are higher
HOLDER RESEARCH INSTITUTE (HRI, LLC.)
3303 Flamingo Drive, Miami Beach, Florida 33140
800-490-7714

PLEASE PRINT OUT & MAIL THIS FORM TO ORDER

Print Order Form