cleavageonline mail order form

We accept all forms of payment including checks, money orders and cash (USD Only). Personal checks normally take up to 10 days to clear. Send a cashier's check or money order for faster turn-around time. Make payments payable to: CleavageOnline. You can also mail us your credit card information if you prefer not using it online.

If you cannot print this form, contact us and we will mail you one. You can also hand write us a note and mail that to us with your payment. Be sure to include all information required below on your hand written note...

Complete All Information, Print Form, Then Mail This Form To:

1980 Edgemere Dr
Rochester, NY 14612

Shipping Information:

First and Last Name:

Address (Street / City / State / Zip Code):


Email Address:

Card Card Information (We Accept Credit, Debit, Pre-Paid and Gift Cards)

Visa / MasterCard / Amex / Discover Card #:

Expiration Date

Product Description

Cleavage Capsules
Cleavage Cream
Cleavage Kit
Expand Male Enhancement
Glutimax Butt Enhancement
Lip Explosion

Shipping Prices - Click to Choose

Total Cost (US Dollars)

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