THE INNER LIGHT SHOPPE
MAIL ORDER FORM

Product
Description

Item
Code

Unit
Price


Qty
Amount
Before
Shipping
        $
        $
        $
        $
        $
        $
        $
        $
        $
        $
        $
        $
        $
      Subtotal
$
      Michigan
Residents
Add 6%
Sales Tax
$
      One-time
Standard
Handling Fee
$     2.00
      Shipping
Cost:
Total from Below
$
      Total
Amount
Enclosed
$
We only ship to the United States and its Territories plus all Provinces of Canada. Print out then hand fill in or
type in your order information then Mail. Any questions call between 9:00 am & 5:00 pm (248) 852-0126
Today's Date: __________________________

BILL TO:
Name:_____________________________________________________________________________________
Address:__________________________________________________________________________________
City:_____________________________________________________________________________________  
State: ________________________________________________Zip Code:__________________________
Day Telephone #:__________________________________Night Telephone #:__________________
Email Address:___________________________________________________________________________

Check here to
SHIP to above address: ____

SHIP TO: (complete if different than above)
Name: ___________________________________________________________________________________
Address:_________________________________________________________________________________
City:_____________________________________________________________________________________
State: ________________________________________________Zip Code:________________________  
ORDERING INSTRUCTIONS:
Print out Order Form! Fill in Credit Card Information or Make Check or Money Order payable to
The Inner Light Shoppe. Then Mail this form to The Inner Light Shoppe (see additional
instructions below).  

Paying By: (check one)
Money Order_____  Cashier Check_____  Personal Check_____  Credit/Debit Card_____

Paying by Credit/Debit Card:
Type of Credit/Debit Card:     Visa_____  MasterCard____  American Express___   Discover Card____
Name on Credit//Debit Card:_____________________________________________________________________________________
Credit/Debit Card Number:______________________________________________________________________________
Expiration Date: ______________________   Security Code (last 3-Digits on Back of Card): ______________
Amount Charging to Credit/Debit Card:  $____________________________
Signature of Person on Card:___________________________________________________________________________

Ordering By Mail:
Complete form with Credit/Debit Card information or make a Cashier Check, Personal Check
or Money Order payable to The Inner Light Shoppe then send to:
The Inner Light Shoppe
P.O. Box 214988
Auburn Hills, MI 48326

*Note:  With every purchase there will be a one-time standard handling fee charge of $2.00 which will be
added to your Shipping Fee whether you buy one or many items.  We only ship to the United States, its
Territories, and Canada.

FREE SHIPPING for retail orders $100 or more!

Shipping Fees Information Below:   
Subtotal of Purchased
Merchandise:
  United States
& Its Territories
  Canada and its Provinces
$0.01 to $7.99
  $3.25
  $6.25
$8.00 to $23.99
  $6.25
  $9.25
$24.00 to $39.99
  $10.65
  $13.65
$40.00 to $99.99
  $12.65
  $16.65
$100 or more
  FREE
  FREE
 
THE INNER LIGHT SHOPPE
Unique Products to Improve Your Life - Body, Mind & Spirit
To Search Our
Entire Website:
___________________
SHOP BY PRODUCT
LINE
___________________
Loretta Marie
Products:
 
Other
Products: