| BILL TO: | SHIP TO: (If Different) |
| Name: | ___________________________ | ___________________________ | |
| Address: | ___________________________ | ___________________________ | |
| City, State, ZIP: | ___________________________ | ___________________________ | |
| Telephone: | ___________________________ | ___________________________ |
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| CB | Country Beans |
$14.95 |
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| NATM | Natural Meals in Minutes |
$15.95 |
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| 123 | 1-2-3- Smoothies |
$14.95 |
||
| PS | Passport to Survival |
$15.95 |
||
| FC | Food Combining |
$7.95 |
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| NSHT | Natural Sweets and Healthy Treats | $7.95 | ||
| QWF-V | Quick Wholesome Foods VHS |
$19.95 |
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| QWF-D | Quick Wholesome Foods DVD |
$19.95 |
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| GSE2 | GSE 2oz Liquid |
$10.95
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| GSE4 | GSE 4oz Liquid |
$18.95
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| GSECAP | GSE Capsules Plus |
$15.95
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| USPS Media Mail Shipping Rates |
0 - $15.95 | $4.00 | ||
| $15.96 - $31.99 | $5.00 | SubTotal | ||
| $32.00 - $63.99 | $8.00 | Shipping* | ||
| $64 AND UP | Free Shipping | Total |
*ALL ORDERS WILL BE SENT USPS MEDIA MAIL.
| Payment Type: | __ Check | __ Money Order |
|
__ Credit Card (MC, Visa, AMEX, Discover) |
Card # ______________________________________________________
Exp. Date: _______
Name (as shown on card): _________________________________________
Signature: ___________________________________________________
Account Security # ___________ (Last 3 digits of the number located on the back of your card.)