Interstitial Cystitis Network Resource List

Order Summary & Details
TOTAL
WEIGHT
TOTAL
SHIPPING
___
Total # of Items Ordered
Subtotal
ICN ANGEL SERVICES 15% DISCOUNT (not including items packaged into promotional kits* OR the angel subscription)
Subtotal After Discount
ICN ANGEL SERVICES AND SUBSCRIPTION (please circle either EMAIL or REGULAR MAIL)
Sales Tax (7.5%) California Residents Only
Shipping Fees: We ship all domestic items by priority mail unless requested
otherwise. Priority mail allows us to ship in flat rate envelopes for smaller orders. Thus,
we can send up to three supplements or two IC Survival Guides in a flat rate envelope
for $4.50. Otherwise, your shipping will be based upon weight. You MAY choose the
flat rate of $4.50 if you are sure that ALL your items will fit into this envelope. We
reserve the right to adjust your shipping rate if they do not. Items that might fit in a
priority mail envelope are marked with an •. If you have any questions about your
shipping rate or if you need an international shipping estimate, please call us at:
(707)433-0413 .
ADD UP ALL THE WEIGHTS IN THE lbs COLUMN NEXT TO THE PRICE COLUMN)
8
PRIORITY MAIL RATES:
0-0.2 = $1.00 7.1-8.0lbs = $14.50
0.21-0.4 = $2.50 8.1-9.0lbs = $16.50
0.41-1.0lb= $4.50 9.1-10.0lbs = $18.50
1.1-2.0 lb = $6.50 10.1-12.0lbs = $22.50
2.1-3.0lbs = $8.50 12.1lbs-14.0lbs = $26.50
3.1-4.0lbs = $10.50 14.1-16.0lbs = $30.50
4.1-5.0lbs = $11.50 16.1-18.0lbs = $34.50
5.1-6.0lbs = $12.50 18.1lbs-20.0lbs = $38.50
6.1-7.0lbs = $13.50 over 20.1lbs = $38.50
$1.50 CANDY SHIPPING SURCHARGE (only required March 1 through September 30)
Total Amount Due
Payment Information
Payment Information: Select Payment Method (Check, Money Order or Credit Card)
Type of Card: (Visa) (Mastercard) (Discover) (AMEX)
Card Owner Name: _________________________________________________________________________
Credit Card Number: __________________________________ Expiration Date: ________________________
Customer Information:
Name: ___________________________________________________________________________________
Mailing Address: ___________________________________________________________________________
City: _____________________________________________________________________________________
State/Province: _____________________ Country: _______________ Zip Code: _______________________
Daytime Phone: ___________________________ Eve. Phone: _____________________________________
E-mail: __________________________________
Placing Your Order
Orders can be delivered to the ICN in four ways:
(1) On the web via our secure web store: http://www.ic-network.com/shop/
(2) By snail mail. Please send your order form to:
Interstitial Cystitis Network
4983 Sonoma Highway, Suite L
Santa Rosa CA 95409
(3) By phone to (707) 433-0413 (to place an order) or (707) 538-9442 (if you need more information) or
(10am-5pm PST)
(4) By Fax to (707) 538-9444
Return Policy & Customer Service
Supplements with missing safety seals, opened Bodiheat Pads, Coffees, Teas, Candies, other Foods, Massage
Oils, Lotions and chair cushions with opened plastic bags and opened tapes or DVD’s are NOT returnable. We
accept the return of most other products within 14 days with a receipt. Please allow 2-3 weeks for shipping. For
additional customer service or information please call our main office at: (707) 538-9442. To place an order or
check the status of your order, please call our mail order office at: (707) 433-0413.