Order Colgate Journey Subscription

Selected Plan Option   
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Base Subscription(Electric) - $30 per 3 month
Dentist Office Visits - $15 per 3 months
Colgate Insight - $100 one time fee


Payment & Billing   
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Visa - XXXX-XXXX-XXXX-XXX

Jon Doe

xx/xx    XXX


Bill To:

Jon Doe
1120 Drayton St
Savannah, GA 31401



Shipping Address   
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Ship To:

Jon Doe
1120 Drayton St
Savannah, GA 31401



Base Subscription(Electric)
Dentist Office Visits
Colgate Insight
$30.00
$15.00
$100.00
Total
$145.00