Payment by check may cause 10 day delay -- money order is quicker
ADVANCED BIO COMPANY "CLICK PRINT"
PO Box 813
Kuna ID 83634
(208) 922-5175
advancedbio.com
Last Name__________________________________________ First_____________________________________Street Address________________________________________________________________________________
City___________________________________ State_____ Zip_____________ Country___________________
Hm Ph ( )______________ Day Ph ( ) _____________ Fax ( ) ____________________
Email: ____________________________ How did you hear about us? ______________________________
Golden Minerals @ 17.95 per bottle (quantity) _______CONTROL APS "Appetite Suppressant" @ $41.50 per bottle (quantity) _______
(replaces "RESULTS")CLENZ @ 34.50 per bottle (quantity) _______
Eassiac Herbal Tea DVD @ 20.00 (free s/h) (quantity) _______
Subtotal $ _________________
Add $0.00 S/H Charge ___FREE__________
Total $ _________________
Choose Payment Option [ ] Check (US Funds only) [ ] Money Order (US Funds only)
Signature _______________________________________________________ Date_______________
Payment by check may cause 10 day delay -- money order is quicker Rev 20081222