Order Form for Natural Medicinal Substances Date: Name/Company: Contact: Ship To Address: Ship To City, ST, ZIP: Tel: Fax: E-mail: Payment Method (Circle One): Cash, Check, Credit Card, or PayPal Y / N Is Shipping Address Same As Billing Address?: If No, Please Enter Bill To Address: Bill To City, ST, ZIP: Iceland Spring Water Product Description List Price per Case Case of 24, 0.5 Liter bottle ($0.89 per bottle) $ 21.36 Case of 12, 1.0 Liter bottle ($1.69 per bottle) $ 20.28 Case of 12, 1.5 Liter bottles ($1.99 per bottle) $ 23.88 Page 1 of 6 QTY Total Price
Dr. Young phlavor Liquid Sea Salt (8 oz. spray bottle) $ 31.99 Dr. Young phour Carbonate Salts (454g powder) $ 41.99 Celtic Sea Salt (Fine Ground) - 1/2 lb. Resealable Bag $ 6.99 Celtic Sea Salt (Fine Ground) - 1 lb. Resealable Bag $ 12.99 Celtic Sea Salt (Fine Ground) - 8 oz. Shaker $ 9.99 Celtic Sea Salt (Flower of the Ocean) - 1/2 lb. Resealable Bag $ 15.99 Celtic Sea Salt (Flower of the Ocean) - 1 lb. Resealable Bag $ 29.99 Celtic Sea Salt (Flower of the Ocean) - 8 oz. Shaker $ 17.99 Celtic Sea Salt (Light Grey Celtic) - 1/2 lb. Resealable Bag $ 2.99 Celtic Sea Salt (Light Grey Celtic) - 1 lb. Resealable Bag $ 5.49 Celtic Sea Salt (Light Grey Celtic) - 8 oz. Shaker $ 5.99 Celtic Sea Salt (Makai Pure) - 3.1 oz. Grinder $ 9.99 Celtic Sea Salt (Makai Pure) - 1/2 lb. Resealable Bag $ 16.99 Celtic Sea Salt (Makai Pure) - 1 lb. Resealable Bag $ 26.99 Celtic Sea Salt (Makai Pure) - 5 lb. Resealable Bag $ 104.99 Celtic Sea Salt (Makai Pure) - 11 lb. Resealable Bag $ 219.99 Celtic Sea Salt (Bath Salt) - 1 lb. Bag $ 5.49 Celtic Sea Salt (Bath Salt) - 5 lb. Bag $ 18.99 Solay Himalayan Crystal Sea Salt (Coarse) - 8 oz. $ 8.49 Solay Himalayan Crystal Sea Salt (Coarse) - 20 oz. $ 13.49 Solay Himalayan Crystal Sea Salt (Coarse) - 5 lbs. $ 38.99 Solay Himalayan Crystal Sea Salt (Fine) - 8 oz. Cotton Bag $ 8.49 Page 2 of 6
Solay Himalayan Crystal Sea Salt (Fine) - 20 oz. Cotton Bag $ 13.49 Solay Himalayan Crystal Sea Salt (Fine) - 5 lb. Cotton Bag $ 38.99 Salt Mill (7" Tall Round) with Ceramic Grinder containing 8 oz. of Himalayan COARSE Sea Salt $ 16.49 Solay Himalayan Salt Stones Starter Jar (2-month supply) $ 16.49 Himalayan Crystal Sea Salt COOKING TILE - (4" x 6" x 1") - Pack of 2 $ 23.99 Himalayan Crystal Sea Salt COOKING TILE - (4" x 6" x 2") - Pack of 2 $ 28.99 Himalayan Crystal Sea Salt COOKING/SAUNA/BED TILE - (4" x 6" x 8") - Pack of 2 $ 33.99 Himalayan Crystal Sea Salt ROUND COOKING PLATE - (8" Diameter) $ 38.99 Himalayan Crystal Sea Salt (Bath Salt) - 1 lb. Cotton Bag $ 8.49 Himalayan Crystal Sea Salt (Bath Salt) - 5 lb. Cotton Bag $ 34.49 Himalayan Crystal Sea Salt (Bath Salt) - 10 lb. Cotton Bag $ 59.49 Himalayan Crystal Sea Salt Lamp - 7" (Small, 5-7 lbs.) $ 33.99 Himalayan Crystal WHITE Sea Salt Lamp - 7" (Small, 5-7 lbs.) $ 38.99 Himalayan Crystal Sea Salt Lamp - 10" (Medium, 9-13 lbs.) $ 48.99 Himalayan Crystal Sea Salt Lamp - 12" (Large, 16-20 lbs.) $ 68.99 Himalayan Crystal Sea Salt Lamp - 17" (X-Large, 28-38 lbs.) $ 138.99 Himalayan Crystal Sea Salt Lamp for Computer - 4" (USB powered) $ 23.99 Himalayan Crystal Sea Salt PLANET Lamp - 6" Globe $ 58.99 Himalayan Crystal Sea Salt PYRAMID Lamp - 5" x 5" Base $ 58.99 Rare Persian White Salt Lamp - up to 6", 2-4 lbs. $ 68.99 Rare Persian White Salt Lamp - up to 8", 4-6 lbs. $ 87.99 Rare Persian White & Purple/Lavender Salt Lamp - up to 6", 2-4 lbs. $ 68.99 Page 3 of 6
Rare Persian White & Purple/Lavender Salt Lamp - up to 8", 4-6 lbs. $ 87.99 Salt Lamp Light Bulb Replacement (15 watts, 110V) - Pack of 6 $ 5.79 Salt Lamp Electrical Dimmer Light Cord $ 14.49 Solay Himalayan Salt Inhaler Pipe with Himalyan Salt and Free Himalayan Salt Refill $ 38.99 Solay Ceramic Neti Pot with 1/2 lb. of Himalayan Salt $ 18.99 Solay Salt Therapy Combo Kit (Inhaler Pipe and Neti/Nasal Pot) $ 49.49 Solay Large Eye and Ear Salt Pillows (8" x 5") $ 19.49 Solay Large Back and Stomach Salt Pillows (16" x 8") $ 35.49 Solay Body Relief Pillows (18" x 5") $ 28.49 Solay Natural Pain Relief Pillow Gift Set (1 x Eye/Ear Pillow, 1 x Back/Stomach Pillow, 1 x Body Relief Pillow) $ 74.49 Solay Himalayan Salt Foot Bed (includes 10 lbs. of coarse Himalayan salt and silk drawstring bag) $ 197.49 Himalayan Salt Lick - 1.65 lbs. (Mini) $ 24.99 Himalayan Salt Lick - 2.2 lbs. (Small) $ 29.99 Himalayan Salt Lick - 6.6 lbs. (Medium) $ 49.99 Himalayan Salt Lick - 11 lbs. (Large) $ 64.99 Flor Blanca Sea Salt (for food, cooking, and bathing) 8 oz. $7.95 Flor Blanca Sea Salt (for food, cooking, and bathing) 16 oz. $11.95 Flor Blanca Sea Salt (for food, cooking, and bathing) 32 oz. $19.95 Flor Blanca Sea Salt (for food, cooking, and bathing) 64 oz. (4 lb.) Container $39.95 Flor Blanca Sea Salt (for food, cooking, and bathing) 128 oz. (8 lb.) Container $79.95 Mayan Sun Sea Salt (for food, cooking, and bathing) 8 oz. $6.95 Mayan Sun Sea Salt (for food, cooking, and bathing) 16 oz. $9.95 Mayan Sun Sea Salt (for food, cooking, and bathing) 32 oz. $16.95 Mayan Sun Sea Salt (for food, cooking, and bathing) 64 oz. (4 lb.) Container $34.95 Mayan Sun Sea Salt (for food, cooking, and bathing) 128 oz. (8 lb.) Container $74.95 Page 4 of 6
Dead Sea Salt (Bath Salt) 8 oz. Container $6.95 Dead Sea Salt (Bath Salt) 16 oz. Container $9.95 Dead Sea Salt (Bath Salt) 32 oz. Container $14.95 Dead Sea Salt (Bath Salt) 64 oz. (4 lb.) Container $27.95 Dead Sea Salt (Bath Salt) 128 oz. (8 lb.) Container $49.95 Page 5 of 6
Zeolite Zeolite Pure - 440 grams of Maximum Micronized Zeolite $ 58.99 Zeolite-AV - 90 Capsules totaling 81 grams of Zeolite and 1.8 grams of Humic Acid $ 38.99 Destroxin - 90 Capsules totaling 72 g of Zeolite, 4.5 mg of B-12, and 6.48 mg of Calcium $ 23.99 Esidifan - 90 Capsules totaling 72 g of Zeolite, 4.5 mg of B-12, and 7.2 mg of Calcium $ 23.99 ZETOX - 6 g of Maximum Micronized Zeolite, 54 mg of B-12, and 12,000 iu of D3 $ 20.99 Dead Sea Mud/Clay Dead Sea "Raw" Therapeutic Mud - 8 oz. Container $9.95 Dead Sea "Raw" Therapeutic Mud - 16 oz. (1 lb.) Container $16.95 Dead Sea "Raw" Therapeutic Mud - 32 lb. (2 lb.) Container $29.95 Dead Sea "Raw" Therapeutic Mud - 64 oz. (4 lb.) Container $49.95 Dead Sea "Raw" Therapeutic Mud - 128 oz. (8 lb.) Container $79.95 Subtotal = **Please fax Order Form back to Creation of the Sea at (908) 269-5591 or e-mail Order Form to info@creationofthesea.com for processing.** **7% NJ sales tax rate (for Bath Salt and Dead Sea Mud ONLY) and shipping & handling (if applicable) to be added at time of processing.** Page 6 of 6