| Invoice No. Mail Order | Date: 09/09/10 |
| Payment Method: Check _____ Money Order _____ | Order Number: MO-1916333 |
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| Item | Description | Qty | Each | Total |
| FemXL | Female Enhancer | $29.99 | $ | |
| Subtotal: | $ | |||
| Shipping: U.S.A. - $5.00 (Flat Rate Up To 4 Bottles) | $ | |||
| Grand Total: | $ | |||
| Make Payment Available To: Great Lakes Nutrition Mail Payment To: Great Lakes Nutrition 8552 Goodale Ave. Utica, MI 48317 United States |
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NOTES: Please do not forget to include shipping fees with your payment or your order cannot be processed. The shipping fees are $5. Please contact customer service if you wish to purchase 5 or more bottles for shipping fees. Please write your order number on your check or money order. The order number can be found at the top right corner of this order form. |