Canada & Mexico Fax or Mail-In Order Form

Fill in this form, print and MAIL to:
Albrite Inc.
P. O. Box 1625 Dept. W
Tarpon Springs, Florida 34688-1625
U.S.A.		 Fill in this form, print and FAX to:
1-727-781-5111 or 1-727-943-7041


Your Name:         
Mailing Address:
City:               State/Province:  
Zip/Postal Code:    Country:            
Telephone:    E-mail:  
Your comments about The Smile Method, the VitaPick or our website will be appreciated. Please enter your four digit  customer number if it is convenient.

The reason the VitaPick works is because it applies antiseptics that kill the harmful bacteria at the base of the deepest pockets."The Smile Method - How to Avoid Gum Surgery and Dentures" Revised second edition by Vas Gardiakos Two high quality (re-usable) VitaPick applicators and
The Smile Method - How to Avoid Gum Surgery and Dentures, 160 p. book

$33.95
order 2 or more at $29.95 each

The reason the VitaPick works is because it applies antiseptics that kill the harmful bacteria at the base of the deepest pockets. Order two additional VitaPick Applicators and Save $3.00! 
Regular $19.95 now $16.95 with order.

$16.95
each pair

Click on photo for more information. Highly Recommended Accessory!
SPANDEX - Simplifies - Saves Time. For details click here.

$9.95
order 2 or more at $7.95 each

There is a flat $6.00 P&H (Postage and Handling) fee regardless of how
many items you order.

$6.00 

Total: We will try to ship your order the same day that it is received.


Please Note:
1. All transactions are in US dollars. 
2. All  orders carry our 60 day money back guarantee.
3. Sorry, we do not offer Express Mail or Overnight Delivery Service.
Choose Payment Method:
1. Mail your check or money order (made from a U.S. bank.) payable to Albrite Inc.
2. Use your VISA or MasterCard: . Fill-in A and B then mail or fax this form.  
A. Your card number:       Expiration Date:   

B. Your signature ______________________________________________________