Its Fast Easy & Simple!  

Print a copy of this form,…. fill it out and include a copy in the box



City   _______________________________State_________________

Zip    ______________

Phone (           ) __________________best time to call day___ nite___

email address _____________________________________________

Make sure to note of any spaces on your email so we get it right!

Please use sturdy box to ship …fill with newspaper to cushion items to prevent damage

Please enter what quantity of test strips (50ct) (100ct)

Example: Qty  2-  Brand   Freestyle lite 100ct

Qty ________   Brand_________________________________

Qty _________  Brand ____________________________________

Qty _________  Brand ____________________________________

Qty _________  Brand ____________________________________

Fast Cash! Select your payment type!

Payment type  – Send check_____   NO PAYPAL 2/17

cut at dotted line and use this for the label for shipping


Send to :

Trader Jack Products

8198 SE Sanctuary Dr

Hobe Sound, FL 33455-3959

Questions?  Use the message center by clicking on the back button

go to bottom of the page.

Thank you for choosing Trader Jack Products!

We really appreciate your business!





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