CLASSIQUE HERBS CORPORATION
Bukidnon, Philippines
ORDER FORM FOR CUSTOMER
CUSTOMER Information




Full Name:
Complete Address:
Nationality:
Country:
Sex:
Status:
Date of Birth
Place of Birth:
Telephone No.:
Mobile No.:
Complete Address Where Delivered the Product:
Date/Days of Delivery
Email Address:
Confirm Email:
Your purchase products (HEALTH BEVERAGES PRODUCTS)
Tsokolatte con AgaricusPhp 385.00/PACK
Baracco Agar.4 in 1 Coffee 20pcs.Php 385.00/PACK
Longevi-Tea Php 245.00/Pack
Ampalaya Tea Php 259.00 Per pack
Nature's Herbs Tonic Drink plus Php 2,730.00
Nature's Herbs Tonic Drink Php 2,520.00
Joint Connection Php1,575.00
Glucan Functional Drink Php 308.00
(FOOD SUPPLEMENT PRODUCTS)
Agaricus Blazei Murill(Blister)Php 392.00
Agaricus Blazei Murill (Box)Php 1,162.00
Glutathione Capsule 983mg/30 Cap Php 1,372.00
Glutathione Capsule 983mg/60Cap Php 2,611.00
Optiberry Plus Capsules 400mg/30 pcs.Php 1,148.00
Diet Rite 30 Cap Php 1,225.00
Bio green Plus(10 sachet/box )Php 1,225.00
Bio green plus(in canesters )Php 2,100,00
(PERSONAL CARE)
Hygiene Soap100g Php119.00
Facial Soap 100g Php 119.00
Cellulite Soap 100g Php 105.00
Anti-Microbial Soap 100g Php 105.00
Skin Whitening Soap 100g Php 105.00
Lauat Saponin Shampoo Php 238.00
Hair Conditioner with Collagen Php 350.00
Blanche Moisturizing Lotion Php 245.00
Crystal Glow Toothpaste Php 196.00

Method of Payment: Western Union
LBC ( HARI NG PADALA)
MONEY ORDER
BANK TO BANK TRANSFER OF MONEY
JR'S
Credit Card (Soon)
Where did you Heard About Us?
Your Text Messages/Comments/Extra Order

create form
HEALTH BEVERAGES,FOOD SUPPLEMENT & PERSONAL CARE
BE NATURAL
IMPROVE HEALTH
IMPROVE LIFE
THE ORIGINAL HERBS PRODUCT:
CONTACT:
MR. VENANCIO B. RANAY
Address: Abaquita Bldg. A. Aguilar St. Purok 16, Poblacion, Valencia City, Bukidnon, 8709 Philippines

Tel# 088-828-2119
Mobile# 09205735954
Email:
venancio_ranay@yahoo.com


ENGR. JOEL L.P- Stockist
Address: M.L. Quezon, St. Purok 8, Fajardo Bldg. Poblacion, Valencia City, Bukidnon 8709 Philippines

Tel# 088-828-1249
Mobile#09177172157
Email:
joperns04@yahoo.com