Bodily Miracles Order Form
Name
*
First Name
Last Name
Email
*
example@example.com
Please list preferred method of contact.
*
Which Bodily Miracles product are you purchasing? (Mark all boxes if all)
*
Body Butter
Body Scrub
Shimmer Fragrance Spray
Lip Balm
Body Scrub Bar
Are you allergic to any of the following ingredients? Shea butter, Cocoa butter, mangos, kokum butter, apricots? if so, please list:
products are mixed with natural oils and essential oils
What is your scent of choice for your Body Butter?
Please Select
Basil
Bergamot
Brownie
Campfire
Chamomile
Chocolate Chip Cookie
Cinnamon
Citrus
Clary Sage
Clove
Coconut
Coffee Cake
Cola
Cupcake
Cypress
Dark Tea
Eucalyptus
Frankincense
Freesia
Fresh Cut Wood
Gardenia
Geranium
Ginger
Grape
Grapefruit
Hot Chocolate
Jasmine
Juniper
Lavender
Laurel
Lime
Lotus
Mango
Mentha
Mugwort
Myrrh
Neroli
Night Air
Nutmeg
Osmanthus
Patchouli
Palmarosa
Peach
Pineapple
Pine Needle
Plum Blossom
Rose
Rosemary
Sandalwood
Smores
Snickerdoodle
Strawberry
Sugar Cookie
Sweet Orange
Tangerine
Tea Tree
Valerian
Verbena
Vetiver
White Tea
Wild Orange
Ylang Ylang
(Scents are used from natural and vegan friendly essential oils)
What is your scent of choice for your Body Scrub?
Please Select
Basil
Bergamot
Brownie
Campfire
Chamomile
Chocolate Chip Cookie
Cinnamon
Citrus
Clary Sage
Clove
Coconut
Coffee Cake
Cola
Cupcake
Cypress
Dark Tea
Eucalyptus
Frankincense
Freesia
Fresh Cut Wood
Gardenia
Geranium
Ginger
Grape
Grapefruit
Hot Chocolate
Jasmine
Juniper
Lavender
Laurel
Lime
Lotus
Mango
Mentha
Mugwort
Myrrh
Neroli
Night Air
Nutmeg
Osmanthus
Patchouli
Palmarosa
Peach
Pineapple
Pine Needle
Plum Blossom
Rose
Rosemary
Sandalwood
Smores
Snickerdoodle
Strawberry
Sugar Cookie
Sweet Orange
Tangerine
Tea Tree
Valerian
Verbena
Vetiver
White Tea
Wild Orange
Ylang Ylang
(Scents are used from natural and vegan friendly essential oils)
What is your scent of choice for your Shimmer Fragrance Spray?
Please Select
Basil
Bergamot
Brownie
Campfire
Chamomile
Chocolate Chip Cookie
Cinnamon
Citrus
Clary Sage
Clove
Coconut
Coffee Cake
Cola
Cupcake
Cypress
Dark Tea
Eucalyptus
Frankincense
Freesia
Fresh Cut Wood
Gardenia
Geranium
Ginger
Grape
Grapefruit
Hot Chocolate
Jasmine
Juniper
Lavender
Laurel
Lime
Lotus
Mango
Mentha
Mugwort
Myrrh
Neroli
Night Air
Nutmeg
Osmanthus
Patchouli
Palmarosa
Peach
Pineapple
Pine Needle
Plum Blossom
Rose
Rosemary
Sandalwood
Smores
Snickerdoodle
Strawberry
Sugar Cookie
Sweet Orange
Tangerine
Tea Tree
Valerian
Verbena
Vetiver
White Tea
Wild Orange
Ylang Ylang
(Scents are used from natural and vegan friendly essential oils)
What is your scent of choice for your Body Scrub Bar?
Please Select
Basil
Bergamot
Brownie
Campfire
Chamomile
Chocolate Chip Cookie
Cinnamon
Citrus
Clary Sage
Clove
Coconut
Coffee Cake
Cola
Cupcake
Cypress
Dark Tea
Eucalyptus
Frankincense
Freesia
Fresh Cut Wood
Gardenia
Geranium
Ginger
Grape
Grapefruit
Hot Chocolate
Jasmine
Juniper
Lavender
Laurel
Lime
Lotus
Mango
Mentha
Mugwort
Myrrh
Neroli
Night Air
Nutmeg
Osmanthus
Patchouli
Palmarosa
Peach
Pineapple
Pine Needle
Plum Blossom
Rose
Rosemary
Sandalwood
Smores
Snickerdoodle
Strawberry
Sugar Cookie
Sweet Orange
Tangerine
Tea Tree
Valerian
Verbena
Vetiver
White Tea
Wild Orange
Ylang Ylang
(Scents are used from natural and vegan friendly essential oils)
Please list your color choice for your products. (if multiples please make a list for each item and what color and scent, note that lip balms are unscented and come in pink or reddish tint)
*
My Products
prev
next
( X )
Body Butter
$15.00
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
Body Scrub
$18.00
$
18.00
Quantity
1
2
3
4
5
6
7
8
9
10
Fragrance Shimmer Spray
$5.50
$
5.50
Quantity
1
2
3
4
5
6
7
8
9
10
Lip Balm
$3.50
$
3.50
Quantity
1
2
3
4
5
6
7
8
9
10
Body Scrub Bar
$8.50
$
8.50
Quantity
1
2
3
4
5
6
7
8
9
10
Submit
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Should be Empty: