ORDER  FORM  ACTIPULSE®  MACHINE

IN EUROS FOR EUROPE

( To order from other country, please open the following page )


PLEASE FILL OUT THIS FORM CLEARLY AND COMPLETELY

ActiPulse exportation price 4,200 Euros:

The complete package contains one ActiPulse® machine (2006 model), one carrying case, 2 head covers in the form of hats with integrated coils, 15 protective caps, one transformer110/220 volts with its adapter plug, instruction manual in English. There is a 150 Euros shipping and insurance fee this thru DHL express.

Two year Guarantee

The unit is very simple to use, place the head cover on and plug it into the ActiPulse machine, set the adjustments according to the chart in English and press the start button to begin the session. The machine will stop automatically according to the time programmed for each session.

This machine is made by Latincom-mex SA Electronics under license Deepers Laboratory Co.

 

Date:

Full Name (first and last name):

YOUR COMPLETE SHIPPING ADDRESS

Street and Number :

Additional Address information :

City :

State, Province, or Department (Faculty):

Zip Code (Postal Code) :

Country :

Phone Number :

E-Mail Address :

YOUR ORDER

ActiPulse Package includes the following: ActiPulse machine (2006 model), one carrying case, 2 head covers in the form of hats with integrated coils, 15 protective caps, one transformer11/220 volts with its adapter plug, instruction manual in English. Total export price 4,200 EUROS (four thousand two hundred Euros).  Click in the box to order 

Optional extra charge for DHL Express Shipping and insurance : 150  Euros (one hundred fifty Euros) for any destination (highly recommended for fast and secure arrival) . Click in the box to accept this shipping option

Additional Notes, Comments, Information (Faculty) :

Your invoice and all export documents will be included with your order

METHOD OF PAYMENT: (we recommend you print this page)

To carry out a transfer in Euros for the total amount of your order from your chosen bank to ours is very simple it will not take more than 5 minutes with the personnel of your bank of choice. Please copy exactly the following information necessary for conducting your bank transfer transaction (we recommend that you print out this form).

BANK ACCOUNT:

BANCO NACIONAL DE MEXICO

Code ABA: BNMXMXMM

International Code: 002849065594202026

Branch : 0655 (Boca del Rio, VER - Mexico)

Beneficiary : LATINCOM-MEX SA de CV - Calle Marte # 18 - 94299 Boca del Rio - Mexico.  Tel: 229 937 96 12

Account to be credited: N° 655 942020-2

Upon completing your transfer, please notify us by Email the following information: issuing bank (name of your bank), transferred amount transferred in Euros, transfer date and the transfer number (very easy, all this information appears on your copy of the bank transfer ). As soon as we receive your order and confirm payment, we will immediately process your order and deliver by DHL Express. The merchandise will arrive in 4 to 6 days.

Our Commitment to our customer: Upon receiving your order and payment, our company Latincom-Mex SA Electronic is committed to carry out the expediting of your order in the indicated time interval. Additionally, you will be informed step by step via e-mail of the status and handling of your order: Confirmation of Order, Reception of Transfer of Payment, Shipment of the Order, and Shipping Information. We sell our products worldwide in over 25 countries and our Export and Expedition of Order Service is safe and reliable as you will be able to verify when you have ordered from us.

Alain Châtillon, Director General, Latincom-Mex SA Electronic

Please feel free to contact us for any further information: deepers@avantel.com