Love-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

Serving You Since 1997

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 Love-Mate Fm^tm..........................$29.95
2 bottles of Love-Mate Fm^tm.........................$56.95
3 bottles of Love-Mate Fm^tm.........................$78.95

Shipping Choices & Charges ( Please choose the one that you would prefer. )

Within the U.S.A. Regular Delivery.....$5.00.
Outside the U.S.A. Regular Delivery ......$5.00.
Within the U.S.A. Same Day Rush Shipping U.S.P.O. PRIORITY MAIL ......$10.00.
Outside the U.S.A. Rush Delivery anywhere in the world Global Priority when available...$15.00.

I am enclosing (Please indicate)
CASH CHECK MONEY ORDER CREDIT CARD/in U.S. Dollars

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

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