ORDER FORM - Continued

Page 2

PRODUCT

QUANTITY

TOTAL

TARGETED PRODUCTS
Antioxidants
  Schizandra ..............................
  Antiox Enhancer ......................
  Vitamin C
    Tablets ...................................
    Chewables .............................
  Sight Saver Formula ................
Calcium Protection ....................
Calmative Spray .........................
Cold Formulas
  Echinacea ................................
  Throat Spray ............................
  Throat Lozenges ......................

Digestive Products
  Aloe Drink
    Ready to Drink Quart .............
    Concentrate - 16 oz ...............
  3-Week Cleanse ......................
    Evening Formula ....................
    Morning Formula ...................
  Friendly Fiber ..........................
Garlic Blend ...............................
Ginko Biloba ..............................
Ginseng Blend ...........................
Herbal Heart Factor ...................
Sleep Natural .............................
PRODUCTS FOR MEN
Prostate Formula .......................
Man’s Choice .............................
PRODUCTS FOR WOMEN
Tang Kuei ..................................
Female Factor ............................

CLICK HERE FOR MORE ITEMS

 

(0022) ___________
(0139) ___________

(0171) ___________
(0172) ___________
(0164) ___________
(0020) ___________
(0137) ___________

(0207) ___________
(0211) ___________
(0208) ___________

 

(0002) ___________
(0006) ___________
(0017) ___________
(0016) ___________
(0015) ___________
(0023) ___________
(0212) ___________
(0160) ___________
(0163) ___________
(0021) ___________
(0138) ___________
 
(0165) ___________
(0024) ___________

(0003) ___________
(0166) ___________

SUB TOTAL
SHIPPING
GRAND TOTAL

 

X $ 17.00 = __________
X $ 26.00 = __________

X $ 7.75 = ___________
X $ 7.75 = ___________
X $ 17.50 = __________
X $ 11.25 = __________
X $ 14.50 = __________

X $ 18.50 = __________
X $ 7.75 = ___________
X $ 6.50 = ___________

 

X $ 17.00 = __________
X $ 27.25 = __________
X $ 29.00 = __________
X $ 16.50 = __________
X $ 12.50 = __________
X $ 13.75 = __________
X $ 20.75 = __________
X $ 18.50 = __________
X $ 16.50 = __________
X $ 27.00 = __________
X $ 14.50 = __________

X $ 19.75 = __________
X $ 44.75 = __________

X $ 13.75 = __________
X $ 25.00 = __________

______________________
______________________
______________________

1- 5 items add
5-10 items add
over 10 items add

$3.00 shipping & handling
$5.00 shipping & handling
$7.00 shipping & handling

PLEASE CHECK ONE

Method of Payment: [  ] Check  Number: ________ Amount: _______
Credit Card: [  ] Visa [  ] MasterCard [  ] Discover
Card Number: ___________________________ Exp. Date: ________
Signature: ________________________________________________

PLEASE PRINT OUT THIS ORDER FORM, FILL OUT COMPLETELY AND FAX TO: 904-255-2897 OR MAIL TO: I CARE ENTERPRISES,
1589 N. NOVA ROAD, SUITE 124, HOLLY HILL, FL 32117