808 S. BLOOMINGTON

LOWELL, AR.    72745

479-770-6027

  NAME _______________________________________________

 STREET ADDRESS_____________________________________

   CITY__________________ STATE _______ ZIP____________

  TELEPHONE (        )___________________

 

QTY

             TITLE

   PRICE

TOTAL

 

Diet and Salad - Vegetarian Guide to

      $7.95

 

 

Fresh Vegetables and Fruit Juices

      $7.95

 

 

Vibrant Health - The Natural Way

      $7.95

 

 

Water Can Undermine Your Health

      $7.95

 

 

Become Younger

      $7.95

 

 

Colon Health

      $7.95

 

 

Weight Control Pure and Simple

      $7.95

 

 

Back To The Land

      $7.95

 

 

Endocrine Chart

      $6.00

 

 

Foot Relaxation Chart

      $6.00

 

 

Colon Therapy Chart

      $6.00   

 

 

POSTAGE  US & CANADA  $1.75 EACH ITEM

ALL OTHER COUNTRIES ADD $4.00 EACH ITEM

                                                                                       Sub Total

    $_________________

                                       _____Items @ $______ EACH Item

    $_________________

                                                                       TOTAL AMOUNT

    $_________________

 

PAYMENT METHOD       _____CHECK _____MONEY ORDER _____VISA _____MASTERCARD

 

CREDIT CARD #______________________________________ EXPIRE_______/_______

 

SIGNATURE ____________________________________________________