Product Order Form
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Where are you purchasing the product(s)?
*
Community Event
EMPOWERED Spaces
Jan's Naturals
Online (select if need product(s) shipped)
Other
Do you need products to be shipped?
Yes, please ship to me. I will be sure to select "shipping cost" in addition to my other products or I understand it will not be shipped.
No, I will pick up in-person
Do you want to receive updates from heARTful wellness?
*
Yes
No
Other
My Products *all prices reflect associated processing fees. Sales tax calculated at checkout. Click on the box in the upper lefthand corner of item(s) you are selecting for purchase and then select quantity for item(s) chosen.
*
Sort By
Name: A to Z
Name: Z to A
Price: Low to High
Price: High to Low
Clear Sort
prev
next
( X )
heARTful wellness sticker
$
3.40
Quantity
1
2
3
4
5
6
7
8
9
10
heARTful magnet
$
5.50
Quantity
1
2
3
4
5
6
7
8
9
10
heARTful pencils
$
5.50
Quantity
1
2
3
4
5
6
7
8
9
10
heART stone
$
8.60
Quantity
1
2
3
4
5
6
7
8
9
10
author signed copy of heARTful wellness workbook
$
20.95
Quantity
1
2
3
4
5
6
7
8
9
10
heARTful wellness workshop gift card
$
63.10
Quantity
1
2
3
4
5
6
7
8
9
10
heARTful wellness workbook (unsigned copy)
$
20.95
Quantity
1
2
3
4
5
6
7
8
9
10
shipping cost
please select if you need products shipped to you.
$
10.60
Quantity
1
2
3
4
5
6
7
8
9
10
Shipping Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Purchase Products Using Payment Methods Below
Once you pay, y
ou will recieve a payment confirmation email
Click on the Debit/Credit option
Manually enter all card information. No Autofills.
Follow the prompts to complete your payment
Do not close registration page until you have completed the payment process
Pay with Credit Card
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
Should be Empty: