Order Form			mail to: Inspired Creations Highway # 3, RR 1, Rock Creek, BC, Canada V0H 1Y0 PHONE: (250) 446-2455 Fax: 446-2862 CANADIAN ORDERS ONLY: 1-800-909-7284
Note: the prices include customs clearance to Canada and include GST. See * for provincial sales tax if applicable.
				Ship to: Phone Number ( ) ______________________________
DATE		PHONE:		Credit Card Number	circle one:	Exp.date
					Visa / MasterCard / cheque
QTY.	Product DESCRIPTION				UNIT PRICE	TOTAL
	PASCALITE - 16 oz Dispenser				$ 29.95
	PASCALITE - 8 oz Dispenser				$ 19.95
	PASCA-DENT tooth powder 6 oz Dispenser				$ 19.95
	PASCALITE Capsules (100)				$ 29.95
	PASCA-PAK poultice 6 oz				$ 19.95*
	PASCA-Balm ointment 6 oz				$ 19.95*
	PASCA-Glow soap 4 oz				$11.95*
	MORE PRECIOUS THAN GOLD (Pascalite history by Ray Pendergraft)				$ 25.95
	NON-PASCALITE PRODUCT: Wolfgang's Oleo MenthaÔ (essential oil - fast acting pain killer for arthritis and migraine pain; external application - 100% money back guarantee)				$ 19.95
SHIPPING & HANDLING: Calculate $9.95 for BC and Alberta, for the first item, then add 95c per additional item; Sask $9.95 for first item;  $ 9.95 first item to Manitoba; $ 11.95 first item Ontario/Quebec; first item to Maritimes: $12.95; always add .95 c per additional item.     The postal rates are subject to change. There is a 5 % GST charge in the above rate. A Transportation surcharge by the post office varies. Subtotal:  AUTHORIZED SIGNATURE FOR CREDIT CARD CHARGE: _____________________________________                                  TOTAL DUE						_______
( *enter only for soap/balm/pack/Oleo shipment in British Columbia) PST TAX 7 %

Inspired Creations is not prescribing, diagnosing or in any way giving medical advise.

For professional health service see your primary health care provider.

We  love Pascalite !

For orders within the United States: mail with cheque

or money order in US-funds to: Pascalite Inc.,

P.O. Box 104, Worland, WY 82401 or

phone: (307) 347-3872 for US price structure.