U.S. Mail Order Form
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Address 1:
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Order Information


I would like to order:

(price includes $A5.95 shipping)

1 bottle of Vilantae Capsules.....$A65.90

2 bottles of Vilantae Capsules.....$A125.85

3 bottles of Vilantae Capsules.....$A185.80

1 bottle of Vilantae
and 1 COLD FUSION acne treatment
.............................$A105.85

1 bottle of Vilantae Powder.....$A60.90

2 bottles of Vilantae Powder.....$A115.85

3 bottles of Vilantae Powder.....$A170.80

1 bottle of Vilantae Powder and 1 COLD FUSION acne treatment
.............................$A105.85

Other: Please specify and add total below:






(please write in and calculate total if ordering more than 3 bottles, or if you would like to order a different product.)
Shipping is a flat $A5.95 regardless of order size.

We will send you an email confirmation as soon as your order ships.

Please print this page and mail with
check or money order to:

Evolution-X Inc.
454 W. Coleman Blvd
Suite 2D
Mount Pleasant, SC 29464

Checks should be written out to Evolution-X. Delivery generally takes 3-4 days from the time we receive your order form.