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AYR DIVERSITIES
AYR GOLD
Therapuetic Products 		POB 3736, Cherry Hill, NJ.  08034
Phone: 1- 856-751-2081
Fax: 1 - 856-751-2956
Name Exactly as on Credit Card:

 Date:

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Payment Method:        Please check one:       Sorry NO COD'S
( )  American Express    ( ) VISA    ( ) Mastercard     ( ) Discover   ( ) Money Order
Card #:                                                             Card Expiration Date:
Qty Item #     Description    Price Ea. Total
  #1001 AYR Platinum Cream   2oz. Jar $24.95 Ea.  
  #2001 AYR Gold Cream   2oz. Jar $24.95 Ea.  
  #3001 AYR Silver Moist. Cream (Unscent)   2oz. Jar $5.00 Ea.  
  #3002 ARY Silver Moist. Cream (Scent)   2oz. Jar $5.00 Ea.  
  #4001 AYR Bronze Shaving Cream   2oz. Jar $5.00 Ea.  
  #5001 Liquid Gold Lotion   2oz. jar $15.00 Ea.  
  #6001 Platinum Liquid Lotion:  Institutional Size with Pump applicator:   Volume Size: 500ml $125.00 Ea.  
  #6002 Liquid Gold Lotion:  Institutional Size with Pump applicator:   Volume Size: 500ml $125.00 Ea.  
     FREE
Creams		 Buy any combination of Three (3) of:
(#1001) AYR Platinum or (#2001) Gold Cream
& Get One FREE! Circle FREE choice above: 		   FREE

SubTotal:

  

Free Shipping for U.S. A. orders only:            Shipping & Handling

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Tax: New Jersey Residents add 6%

 

Thank you for ordering AYR GOLD Products          Grand Total:

  

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