Order Form

(Only for oversea clients )

œPlease check [order] of an order column without fail, in the case that you order. Also, please enter [quantity] without fail.
On January 17th,2006, 1 US dollar($) is equal to 115.Japanese yen(\).
So \7,000(Japanese yen) is equal to $60.68(US dollars).

œPlease Note: If you do not wish to have your Credit Card Number sent across the Internet, Please print this page and Fax or send it to us.
Product name Capacity Price Order Quantity
Chlorella"Green Treasure" grain 700 grains (140 g)/
1 can		 Yen 7000 order
Chlorella"Green Treasure" grain 3 cans Yen18000 order
Chlorella"Green Treasure"grain 6 cans Yen33000 order
C G F "Biogreen G" ( 50ml*10 bottles) /
1 box		 Yen15000 order
C G F "BiogreenG" 3 boxes Yen36000 order
A set "Biogreen G" 1 box+"Green Treasure" 3 cans Yen32000 order
B set "Biogreen G" 3 boxes+"Green Treasure" 3 cans Yen53000 order
C set "Biogreen G" 3 boxes+"Green Treasure" 6 cans Yem68000 order
S set "Biogreen G" 6 boxes+"Green Treasure" 6 cans Yen104000 order
Chlorella"Ggreen Treasure" powder (150 g)/
1 can		 Yen6000 order
Chlorella"Green Treasure" powder 3 cans Yen15000 order
Chlorella" Green Treasure" powder 6 cans Yen28000 order

*Please add shipping fee (by air mail):JPYen 2,000.

Subtotal cost \
Shipping fee JPYen 2,000.
Total cost \
Mr.Mrs.Miss.Ms.Dr.
First Name: Last name:
Street Address:
City:
State/Province
Zip/Postal code:
Country:
Phone: FAX:
E-mail:
Company Name:(if applicable)
Name on Card:
VISA@MASTER@UC Diners
Bank credit card number:
Name:(as it appears on credit card)
Expiration Date:MonthYear

¦ Please complete the above order form to order product(s) from us. Thank you very much for your kind interest.
¦ Please allow 7 to 8 days for delivery on foreign orders.
¦ If you need us to help you by using other payment methods, please send E-mail:health@chlorellacenter.com directly to Chlorella Center Company Limited, we would be very pleased to response to you as soon as possible as we can.

When you have filled in all the relevant boxes click Sumit to send your order.

Please send any additional questions or comments to health@chlorellacenter.com

An inquiry is also accepted by the following FAX.

Chlorella Center Co., Ltd

7-7 Kamigobyonocho Misasagi Yamashina-ku Kyoto 607-8425 Japan
TEL 81-75-502-2131 FAX 81-75-595-3331

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