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Mail Ordering Instructions:
Print & Fill out this form.
Mail with check, credit card or debit card information.(or)
Fax with credit card or debit card information.
PGM Incorporated
P.O. Box 2106
Middleburg , FL. 32050
PH: (904)966-0600
FX: (904)966-0601
Continental U.S - Contact us for Freight charges outside the continental U.S. .

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Ph:*

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Shipping Address:

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E-Mail:*

You can mix and match bottles in each case 1 case of 4 - 16oz. bottles:
$24.00 + $15.95 S&H
(Continental U.S. only) $39.95 ea.
1 case of 12 - 16oz. bottles:
$60.00 + $19.95 S&H
(Continental U.S. only) $79.95ea.
  Case #1 Case #2 Case #3 Case #4 (more)
Case of 4 or 12 bottles

# of Original bottles

# of Inferno bottles

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Discover Card
Card Type: *
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Card Number*:
Pin #*:
(for AMEX,
the pin# is on front of card
and is 4 digits)
  
Pay by mail
check:
Expiration Date: *
Total:
 

 

  

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