CCA Direct Order Form

CCA DIRECT ORDER FORM

Dear Valued Customer:

Thank you for contacting CCA Direct. There are four easy ways to order your favorite products;

please choose the method that is most convenient for you:

1. US Mail: CCA Direct Order Processing, PO Box 7486 E. Rutherford, NJ 07073

(If order via US Mail, please ensure you fill out the form below)

2. E-Mail: amberyoung@ccaindustries.com

3. Phone: Toll free (800) 524-2720, extension 175

4.Fax: (201) 935-4158

NAME:____________________________________________________________________________

ADDRESS:________________________________________________________________________

CITY: _________________________________ STATE: _____________ ZIP: ____________

DAYTIME PHONE:____________________________ EVENING PHONE:____________________________

E-MAIL:__________________________________________________________

ITEM #

PRODUCT NAME

PRICE

QUANITY

TOTAL $

PURCHASE TOTAL	SHIPPING FEE
U.S.A. ONLY - UNDER $50.00	$4.00
U.S.A. ONLY - $50.00 to $100.00	$6.00
U.S.A. ONLY - $100.00 +	$8.00

Sub-Total

NJ Residents add 7% to Sub-Total

Add Shipping & Handling

Total

***International Orders***
All orders placed outside of the United States and its territories, must be ordered via phone.
We apologize for any inconvenience.
To place your order please call: 1-201-935-3232 ext.175

*There is a minimum $15.00 order requirement for all orders

*If you are paying by check or money order, please make payable to CCA Direct

for the exact amount of your total order (US currency drawn on a US bank only)

*If you are paying by credit card, please supply:

Account Number: ___________________________ Exp. Date: Month ______ Year _______

Signature of account holder:_______________________________

All Credit Card Orders will require a signature when the package is delivered via UPS and will not be shipped to post office boxes.

SUDDEN CHANGE® SKIN CARE PRODUCTS
ITEM #	PRODUCT	SIZE	PRICE	ITEM #	PRODUCT	SIZE	PRICE
6032	Sudden Change® Under-Eye Firming Serum	.23 fl oz /7ml	$12.00	6077	Sudden Change® Eyelid Lifter Creme	1.0 oz /28.35g	$10.00
6092	Sudden Change® Gaba-Freeze Creme	1 oz/30g	$15.00	6136	Sudden Change® Lip Base Coat w/ Vitamin E & SPF 15	.12 oz /3g	$5.00
63132	Sudden Change® Instant Under-Eye Firming Serum (Purse Size)	.10 oz	$5.00	6084	Sudden Change® Dark Circle Fade Crème	.06 oz /1.7g	$10.00
6094	Sudden Change® Greejn Tea Facial Serum Therapy	1.7 oz /50ml	$10.00	6091	Sudden Change® Recovery Cream with Green Tea	3.4 fl oz	$10.00
6097	Sudden Change® Green Tea Night Repair Cream	.75 oz /21g	$10.00
6042	Sudden Change® Instant Eyebrow Shapers	18 Sets	$4.50
6090	Sudden Change® Green Tea Facial Cleansing Mousse	5 fl oz	$9.00
6076	Sudden Change® Green Tea Facial Peel	4 packets	$10.00
SCAR ZONE®
6087	Scar Zone® Scar Diminishing Cream w/ SPF 15 With Green Tea	1 oz /28g	$10.00	6167	Scar Zone® A Acne Treatment & Scar Diminishing Cream With Green Tea	0.5 oz /14g	$6.00
6169	Scar Zone® Burn Gel With Green Tea	0.5 oz /14g	$6.00		6154	Scar Zone® Stick Scar Treatment With Green Tea	.45 oz	$10.00
6172	Scar Zone® Scar Diminishing System	kit	$20.00

BIKINI ZONE®
1601	Bikini Zone® Medicated Crème	1 oz	$7.50	1623	Bikini Zone® Ultra-Smooth Bikini Crème Hair Remover	2 oz	$5.99
1604	Bikini Zone® Medicated Gel	1 oz	$7.50	1622	Bikini Zone® Ultra-Smooth Bikini Wax	2 oz/ 10 cloths	$5.99
1608	Bikini Zone® Anti-Bumps Medicated After-Shave Gel	1 oz	$7.50	1619	Bikini Zone® Anti-Bumps Bikini Waxing Kit	1 kit	$10.00
1605	Bikini Zone® Anti-Bumps Shave Gel For Bikini Area	4 oz	$4.50	1616	Bikini Zone® Ultra-Moisturizing Shave Gel with Cucumber Melon (for legs & underarms)	4 oz	$4.50
1611	Bikini Zone® Medicated Bikini Pads	60 pads	$8.00	1617	Bikini Zone® Sensitive Skin Shave Gel	4 oz	$4.50
1600	Bikini Zone® Anti-Bumps Bikini Crème Hair Remover Kit	1 kit	$10.00	1610	Bikini Zone® Ultra-Soothing After-Shave Lotion	5 oz	$7.60
1636	Bikini Zone® Wax Strips	18 dbl sided strips	$5.99
HAIR OFF® HAIR REMOVAL PRODUCTS
1020	Hair Off® Instant Eyebrow Shapers	18 Sets	$3.40	1102	Hair Off® Crème Facial Hair Remover	1.8 oz	$6.00
1021	Hair Off® Brow Stencils	12 Sets	$3.40	1104	Hair Off® Facial Wax Strips	18 sets	$6.00
1022	Hair Off® Hair Remover Mitten	3	$5.20
1028	Hair Off® Facial Buffer Refills	6 Strips	$3.50
1026	Hair Off® Facial Buffer	1 Buffer /3 Stripes	$5.20
PLUS WHITE® ORAL CARE PRODUCTS
7610	Plus White® 5 Minute Speed Whitening Kit withTartar Control Whitening Rinse	Kit	$10.00	27237	Plus White® Xtra Whitening Cool Mint Gel Toothpaste	3.5 oz	$4.20
7605-032	Plus White® Mouth Tray	1 Tray	$1.11	27236	Plus White® Smokers Toothpaste	3.5 oz	$4.20
22221	Plus White® 5 Minute Teeth Whitener Bleaching Gel	1 oz	$2.00	27613	Plus White® 5 Minute Whitener Gel	3 oz	$4.20
27224	Plus White® Coffee Stain Removing Toothpaste	3.5 oz	$4.20	27616	Plus White® 5 Minute Speed Whitening Gel	3 oz	$6.00
27233	Plus White® Xtra Whitening Toothpaste With Peroxide	2 oz	$4.20	28613	Plus White® 5 Minute Speed Whitening Gel for Sensitive Teeth	3 oz	$6.00
27243	Plus White® Xtra Whitening Toothpaste	3.5 oz	$4.20	7618	Plus White® Speed Whitening Kit	kit	$19.95
SOLAR SENSE® SUN PROTECTION PRODUCTS
17303A	Solar Sense® SPF 45 For Face (carded jar)	.50 oz	$3.00	17445A	Solar Sense® SPF 45 For Face (Carded Stick)	.45 oz	$4.20
17215	Solar Sense® SPF 45 For Body (lotion)	5 fl oz	$10.00	17213	Solar Sense® Continuous Spray SPF 45	5 fl oz	$10.00
MEGA-T DIETARY PRODUCTS
0183	Mega-T® Green Tea Dietary Supplement	14's	$4.50	17889	Mega-T® Green Tea Weight Loss Packettes with Hoodia- Mixed Berry Flavor	30 svgs/ 160g	$14.99
0171	Mega-T® Green Tea Dietary Supplement	30's	$6.50	0181	Mega-T® Green Tea Water Weight Loss Pill	28's	$6.29
0173	Mega-T® Green Tea Dietary Supplement	14's	$4.00	1771	Mega-T® Green Tea Liquid Drops	1 fl oz/30 ml	$10.00
0174	Mega-T® Green Tea Caffeine Free Dietary Supplement	30's	$6.00	0155	Mega-T Plus	30's	$11.99
0175	Mega-T® Green Tea Fat Burning Supplement	90's	$15.00
0176	Mega-T® Green Tea Dietary Supplement	30's	$6.00	MEGA-T GREEN TEA GUM & MINTS
0170	Mega-T® Green Tea Caffeine Free Dietary Supplement	90's	$15.00	1912	Mega-T® Green Tea Chewing Gum	12's	$2.50
1763	Ultra Mega-T® Green Tea Dietary Supplement	90's	$20.00	1902	Mega-T® Green Tea Chewing Gum	24's	$5.00
18866	Mega-T® Green Tea Drink Mix - Natural Lemon Flavor	30 svgs/ 160g	$8.00	1931	Mega-T® Green Tea Mints	12's	$2.50
18867	Mega-T® Green Tea Drink Mix - Natural Peach Flavor	30 svgs/ 160g	$8.00	1930	Mega-T® Green Tea Mints	48's	$5.00
18868	Mega-T® Green Tea Drink Mix - Natural Berry Flavor	30 svgs/ 160g	$8.00

WASH 'N CURL®
13951	Wash 'N Curl® Curling Shampoo for Damaged, Color Treated Hair	8 oz	$4.20	13631	Wash 'N Curl® Curl-Lock® Conditioner for Damaged, Color Treated Hair	8 oz	$4.20
13952	Wash 'N Curl® Curling Shampoo for Fine, Limp, Dry Hair	8 oz	$4.20	13632	Wash 'N Curl® Curl-Lock® Conditioner for Fine, Limp, Dry Hair	8 oz	$4.20
NUTRA NAIL® TREATMENT LINE
ITEM#	PRODUCT	SIZE	PRICE	ITEM#	PRODUCT	SIZE	PRICE
1200	Nutra Nail® 5 To 7 Day Growth Formula w/ Protein	.45 oz	$5.20	12643	Nutra Nail® Brush-On Polish Remover with Green Tea	1.0 oz	$5.20
1223	Nutra Nail® Maxium Hardener	.50 oz	$5.20	1222G	Nutra Nail® Green Tea Nail Strengthener	.50 oz	$3.00
1223G	Nutra Nail® Nail Green Tea Hardener	.50oz	$5.20	12669BR	Nutra Nail® Green Tea Growth Treatment	.38oz	$5.20
1241	Nutra Nail® 5 To 7 Day Growth Formula w/ Calcium	.45 oz	$5.20	1229	Nutra Nail® 5 To 7 Day Growth w/ Aloe	.45oz	$5.20
1245	Nutra Nail® Power Gel Nail Hardener with Green Tea	Kit	$10.00	12661G	Nutra Nail® Green Tea Cuticle Remover	.45 oz	$3.00
12451	Nutra Nail® Power Gel Replacement Gel	.17oz	$6.00	12528	Nutra Nail® Finger, Nail and Cuticle Creme	.50 oz	$5.20
12565	Nutra Nail® One Step Liquid Wrap	.25 oz	$5.20	12665	Nutra Nail® Magic Growth	.45 oz	$5.20
12667	Nutra Nail® Green Tea Antimicrobial Nail Solution	1 oz	$9.99	12666BR	Nutra Nail® Bullet- Proof Strength	.50 oz	$5.20
12715	Nutra Nail® Thickener Plus Green Tea Antioxidants	.50 oz	$5.20	12642	Nutra Nail® Total Nail Care 5 in 1 plus Green Tea	.50 oz	$9.99
12546	Nutra Nail® Triple Power Gel Strengthener	.50 oz	$5.20	12661	Nutra Nail® 30 Second Cutile Remover	.45 oz	$5.20
12548	Nutra Nail® Growth Maximizer	.50 oz	$5.20
NUTRA NAIL® ADVANCED FORMULAS
12890	Nutra Nail® Advanced Formula Super Growth	.45 fl oz	$6.99	12892	Nutra Nail® Advanced Formula Super Thick	.50 fl oz	$6.99
12891	Nutra Nail® Advanced Formula Super Base Coat	.50 fl oz	$6.99	12893	Nutra Nail® Advanced Formula Super Tuff	.50 fl oz	$6.99
VANILLA COLLECTION FRAGRANCE
60030	Cherry Vanilla® Fragrance	1 oz	$10.00	46501	Strawberry Vanilla	1 oz	$10.00
68055	Cherry Vanilla® Fragrance Clam Shell	.50 oz	$5.00	46001	Wild Berry Vanilla Fragrance	1 oz	$10.00
46701	Vanilla & Lavender	1 oz	$10.00	70001	Mandarin Vanilla	1 oz	$10.00
46601	Tropical Vanilla	1 oz	$10.00	67330	Cherry Vanilla with Angel Bear	1 oz	$10.00
LOBE WONDER™ EAR LOBE SUPPORT PATCHES
88326	Lobe Wonder™ Ear Lobe Support Patches Bonus 40% More	84's	$6.00
IPR-3® FOOT CARE PRODUCTS
1300	IPR-3® Hard Corn Remover	1 Silica Pad	$3.40
YOU'RE THE MAN™
1500	You're The Man™ Shave Zone™ Medicated After-Shave Gel	1 oz	$7.50