Bravo Smokes - the Easy way to stop smoking!

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Bravo Smokes Corporation Phone Order Form

Required Fields are labeled in red

To order Bravo Smokes Kits by phone, please call :

1-201-944-0440

We show our standard order form below. You of course do not have to fill this out, but please have the information requested below available when you call.

Please send me :
Heavy Smoker's Survival Kits @ $87.50 per kit (shipping included)
Light Smoker's Survival Kits @ $55.50 per kit (shipping included)

Name	______________________________________
Phone Number	______________________________________
Email Address	______________________________________

Bill To Information :
Address	_____________________
Address	_____________________
City	_____________________
State	_______
Postal Code	______________
Country	______________

Ship To (if different from Bill To) :
Name	_____________________
Address	_____________________
Address	_____________________
City	______________________
State	_______
Postal Code	______________
Country	______________

Payment Information

Card Type *

______________

Name on Credit Card *

______________________________________

Credit Card Number *

______________________________________

Expiration Date (enter MM/YY) *

______________

Return Policy : You may send back any unopened, undamaged packs of smokes that are suitable for resale. Bravo Smokes will refund $3.50 per pack up to and including one-half the orginal order's number of included packs. The shipping charge is not included in the refund.

Please be sure that your return shipment is well packaged so that the carton isn't damaged during its return to us.

Please allow 10 business days for delivery. Order a sufficient quantity of Bravo® Smokes to replace two weeks of your regular cigarette usage. Your order will ship via UPS, or US Postal Service Priority Mail.