Love Mate 2000 and Love Mate Fm Pheromone Mail In/ Fax FormLove-Mate 2000 and 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 A)Love-Mate 2000tm Pheromone for Men 1 bottle of Love-Mate 2000tm..........................$29.95 2 bottles of Love-Mate 2000tm.........................$56.95 3 bottles of Love-Mate 2000tm.........................$78.95 1 bottle of Love-Mate Fmtm..........................$29.95 2 bottles of Love-Mate Fmtm.........................$56.95 3 bottles of Love-Mate Fmtm.........................$78.95 C)(Mixed order) Love-Mate Fm for Women and Love-Mate 2000 for men 1 bottle of Love-Mate 2000 and 1 bottle of Love-Mate Fmtm..........................$56.95 1 bottle of Love-Mate 2000 and 2 bottles of Love-Mate Fmtm..........................$78.95 2 bottles of Love-Mate 2000 and 1 bottle of Love-Mate Fmtm.........................$78.95 3. 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