Crystalized Marvels

Please send only Personal Checks or Money Orders at this time.  They should be written out to Pat Dasenbrock, NOT Crystalized Marvels!!  Please mail to:

                                                              Pat Dasenbrock
                                                              P. O. Box  73112
                                                              Newnan, GA  30271

The following personal information is needed for your Rock Salt Order:

First Name  ______________________________                                       (Required)
Last Name  _____________________________                                          (Required)
Mailing Address with Zip Code  _______________________________   (Required)
Primary E-Mail Address __________________________________           (Required)
All Contact Phone Numbers  __________________________________  (Required)
Referred by ______________________________________________       (Required)

For EACH Item ordered, the following information is required on the Order Form:
[ Please See Below ]

Item Stock No.                                       Price
Item Description                                    Shipping Total (Be sure to multiply by EACH Item)
Item Weight                                           Sub Total for Each Item
Quantity for Each Item                          Grand Total for Entire Order

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For your convenience, below are:

 a  SAMPLE  Order Form
 an  ACTUAL Order Form
 and a Wish List Form

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SAMPLE Order Form :

Name:        Some Body
Address:   1234 Some Lane, City, State, Zip Code
E-Mail:      mssomebody@mail.com; msotherlady@email.com
Phone:       H- 123-456-7890 / O- 456-123-0987 x122 / C- 654-321-7809 or 7810
Referred by:  _____Serenity Lakes Wellness Center__________

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ACTUAL Order Form :

Your Name:  
Your Address [incl. Zip Code]:  
Your E-Mails:      
Your Phone Numbers [incl. Cells]:     
Referred by:

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Please copy and paste your Order Form
and E-Mail:  order@patdf.com 
or Snail Mail to me [address above]
with the Contact Information on this page.

   In addition to ordering Wholesale through my website, 
you pay only 50%  Shipping Costs!!!!  
Double Savings for YOU!!!

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Wish List Form
for Your Future Orders:

If you need more information or have any questions, please contact me via E-Mail or phone:

 order@patdf.com

info@patdf.com

770-252-9310