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Fill in the form below with the quantities of the items you want.

Item #	Product Description	Price per item	Quantity Ordered
001	MAX!^tm Dirk Pearson & Sandy Shaw	$22.50
003	MAX!^tm Capsules Dirk Pearson & Sandy Shaw	$22.50
012	Concentration^tm Dirk Pearson & Sandy Shaw	$22.50
015	Powerfit^tm Dirk Pearson & Sandy Shaw	$23.50
020	Body Tea^tm Dirk Pearson & Sandy Shaw	$20.50
1601	Radical Sheild^tm Dirk Pearson & Sandy Shaw	$32.95
3521	For Your Hair^tm Dirk Pearson & Sandy Shaw	$27.95
311	DHEA Spray	$18.95
411	Control^tm	$23.50
401	BODYTABS^tm	$27.50
331	GMS	$22.50
101	Essential Care^tm A.M.	$22.95
102	Essential Care^tm P.M.	$22.95
112	Essential Care^tm A.M / P.M..	$42.95
200	Attention^tmStop Ritalin Abuse!	$22.50
202	Junior Care Pops^tm	$14.00
CM301	Calorad	$55.00
5101	Natural Sex for Women	$46.95
5201	Natural Sex for Men	$39.95
600	Euro-Wash Laundry Ball 3,500 Washes!!	$45.00

Shipping added at the following rates:1-3 items-$5.00, 4-7 items-$8.00, 8 & up .50 per item. UPS 3-day 1-3 items-$7.50, 4-above add 0.75 per item.

Ship to Information:
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Address
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Bill to Information(if different)
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Address
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Exp. Date(0101)
Type
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Confirmation of order will be sent with total charges.