| EYE KANDY Cosmetics Order Form |
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| Send Printed Order From with Check( US funds only) made to: |
| IMBellyVP, 3626 Thomas Ave. Berkley MI 48072. |
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| Quality | Product Request | Price | Total |
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| Kandy Bag Kit with ONE Color Pod | $24.95ea | |
| (with 1oz. Liquid Sugar Base & Brush) |
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| Extra Individual Kandy Color Pod | $6.00ea. | |
| with Kandy Bag Kit Purchase |
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| Individual Kandy Color Pod | $7.50ea | |
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| Individual Liquid Sugar Base (1oz.) | $16.95ea | |
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| Product Total | |
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| Add MI Sale Tax 6% | |
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| Add Shipping | $5.00 |
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| Total | |
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| Mailing Info: |
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| Name: | |
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| Address: | |
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| City: | | Zip: | |
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| Email: | | Phone: | |
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| Please allow 10-14 Business days to receive your order, thank you for your purchase. EyeKandyman@yahoo.com |