Please print out this order form ! Fax orders to (509) 248-8864 or Mail to: Gunderson Enterprises. 732 Summitview Ste. #724, Yakima, WA, 98902, USA. Payment Method: Please select one! [ ] MONEY ORDER [ ] CHECK (30 days) [ ] Credit Card (Very Fast) Recommend: Credit Card or Money Order Note: Buy a money order from post office. (It is very easy !) Payable to: Gunderson Enterprises. 732 Summitview Ste. #724, Yakima, WA, 98902, USA. Fax: (509) 248-8864 Shipping Information ======================================================== First Name:_______________ Last Name:____________________ Address:________________________________ City:__________________ State: _____ Country: _____ Phone:_________________ Email: _________ Age: _______ If pay by Credit Card: Card Type: [ ] Visa [ ] Master Account Number:_________________________________ Expiration Date: _______________________________ Name On Card: __________________________________ ORDER FORM ============================================================ SPECIAL OFFER ! CIRCLE PRICE Order 1 bottles for $29.95 Order 2 bottles for $56.95 Order 3 bottles for $78.95 Shipping and Handling $5.00 ============================================================ Qty Item Price Amount ------- ------------------------------------ ----------- ___Date-Mate 2000 for MEN to attract WOMEN US$29.95 EACH ___Love-Mate 2000 for WOMEN to attract MEN US$29.95 EACH Basic Shipping & Handling Charge $5.00 Special RUSH Orders add US$5.00 (USA)US$_______ Special RUSH Orders add US$10.00 (Below Country) US$_______ Regular delivery.(Anywhere in the World) US$5.00 Please allow 1-3 weeks for delivery! (Or Less) We ship within 24 hours! MONEY BACK GUARANTEE: If, for any reason, you are not delighted with our products, simply return the unused portion within 30 days for refund NO QUESTIONS ASKED. (Shipping and Handling Charge is not refundable.) ** All orders billed discretely and shipped in plain unmarked wrapper. ** You will not be put on any mailing list. Customer discretion is assured. ** All amounts will be charged in US$ -----------------------------------------------------------