Mandura Mail Order Form

Mandura Order by Mail Form
Print and mail this document to:
Advanced Marketing, 2050 Beavercreek Rd., #310, Oregon City, OR 97045
PAID to: Advanced Marketing

Full Name:

Street address :

_________________________________________________________________________

Phone:____________________ Fax:_______________________

E-mail:

Order Form:

Price:

Quantity:

1 - 32oz Bottle

$35.00

______

2 - 32oz Bottles

$65.00

______

1 case - 4 32oz Bottles

$115.00

______

Shipping Included in Price and shipped Priority Mail

All prices are in US dollars.

Message:__________________________________________________

Information Package? Yes or No (Please Circle)

Send Money Order for faster delivery, if Check waits to clear with bank.
Payment to: Advanced Marketing