GOUTWELL.COM  Mail Order Form
                                      (You can complete the form and print out)
Product Code: Healthy Prostate & Ovary
Please make checks or money orders
payable to: GetWell International, Inc.
Quantity
 Cost
 Shipping +
Handling
 Total
1
 $50.00
 $7.50
 $57.50
2
 $92.50
 $7.50
 $100.50
3
 $127.50
 $7.50
 $135.00
4
 $170.00
 $7.50
 $177.50
5
 $212.50
 $7.50
 $220.00
Mail this form with your payments to:

Goutwell.com/ GetWell International, Inc.
4155 Moorpark Ave.,
Suite #20
San Jose, CA 95117
California residents, please add 8.25% sale tax.
For outside USA orders, please add $29.95 (instead of $7.50) for Shipping and Handling cost.
Thank you for your order. Please print out this form and mail with your payments.
Copyright © 2004 Goutwell.com/Fuma Natural   - All Right Reserved.  - 12881 Knott Ave., Ste 113, Garden Grove, CA 92841


Shipping Information: