Print off this form and send it with your cheque to the address at the base of the form

Name:
 
 
Delivery Address:
 
 
 
 Post Code

Telephone

Number

 

Email Address

 
Description Unit Cost Quantity Total
Immediate Thermoform Tray Kit

£99-00

   
LabMade Custom Tray Kit £115-00    
Standard Refill Kit - 3 x 10% VOCO Gels

£40-00

   
Standard Refill Kit - 6 x 10% VOCO Gels

£65-00

   
Excell Refill Kit - 3 x 17% VOCO Gels £50-00    
Excell Refill Kit - 6 x 17% VOCO Gels £75-00    
Replacement Thermoform Mouth Tray £ 5-50    
Weekender Case for Bleaching Kits £ 9-50    
Mouthguard/Bleaching Tray Case £ 3-50    
Junior Sports Mouth Guard £ 4-50    
Adult Mouth Guard £ 4-00    
Total including FREE post and packing  £

For Mouthguard Orders please state colour preferred ..............

Orders are usually despatched within 7 days.

The completed order form and cheque made payable to 'WHITE FANGS' should be sent to:

White Fangs Phone:  02392 482949
P.O. Box 156 Fax:  02392 482949
Havant  PO9 1ZT Email:  info@whitefangs.co.uk