Love-Mate Fm and Date-Mate Fm
Pheromone Attractant Fax / Mail in Form
Print this form for mailing and faxing
VISA/MC/Discover/AmerExp/CASH CHECK/MONEY ORDER
Print this form fax to: Fax# 1- 509-248-8864
Instructions
for E-Mail orders:
Fill out order
page, go to; Edit, Select All, Copy, Paste to E-Mail Page,
Now Fill out the rest of the order form. Send to:
kenny@kennys-ins.com.
A)Love-Mate Fm Pheromones for Women
1 bottle of Date-Mate Fmtm..........................$29.95
2 bottles of Date-Mate Fmtm.........................$56.95
3 bottles of Date-Mate Fmtm.........................$78.95
B)(Mixed order) Love-Mate Fm for Women and Love-Mate 2000 for men
1 bottle of Date-Mate Fmtm
and 1 bottle of Love-Mate Fmtm..........................$56.95
1 bottle of Date-Mate Fmtm
and 2 bottles of Love-Mate Fmtm..........................$78.95
2 bottles of Date-Mate Fmtm and 1 bottle of Love-Mate Fmtm.........................$78.95
3. Shipping Choices & Charges ( Please choose the one that you would prefer. )
ACCOUNT #_____________________________________
EXPIRATION DATE__________________
Signature_______________________________________
Name__________________________________________
Address________________________________________
City_____________________________State__________Zip Code_____________
Email Address_________________________Phone#________________________
Shipping Address if Different from above address
Address________________________________________
City_____________________________State__________Zip Code_____________
MAIL TO:
Gunderson Enterprises
732 SUMMITVIEW STE. # 724
Yakima, WA 98902-3032
Fax# 1-509-248-8864