Rub On Relief - Print Order Form by zhangyun

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									                                            The Healthy Back
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                         Rub On Relief - Print Order Form
                                Like everyone else who has tried Rub-On-Relief, you'll be amazed at how fast and
                                effective it is. Remember, with our "100% Money-Back Guarantee" you've got
                                nothing to lose by trying it. Now it's time for you to put this amazing formula to
                                work for you! And to take back your life so you can be Pain FREE!

                                Please choose your quantity

                              Best Deal            6 tubes + 3 FREE – $139.95 (Shipping $10 U.S., $20 Int.)
                                                   3 tubes + 1 FREE – $69.95 (Shipping $8 U.S., $16 Int.)
                              Good Deal
                                                   1 tube – $24.95 (Shipping $6 U.S., $12 Int.)

                                                                                                        For Fastest Service
                                                                                                        1. Call Toll-free
Method of Payment                                                                                           888-343-3488
   Check or Money Order made payable to The Healthy Back Institute                                          Outside the US please call:
                                                                                                            (+1) 306-791-5110
   VISA     MasterCard      American Express       Discover                                             2. Fax your credit card order to:
                                                                                                            1-866-843-4319
Credit Card # _____________________________ Exp. Date ____________
                                                                                                        3. Mail your completed order
Signature _______________________________ Security Code _________                                           form with payment to:
                                                                                                            The Healthy Back Institute
Customer Contact Information                                                                                333 Main Street, Suite 201
                                                                                                            Gaithersburg, MD 20878, USA
Name ________________________________________________________

Email ________________________________________________________
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Phone ________________________________________________________
       (in case we have a question about your order)                                                                      CUSTOME
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Billing Address                                                           Shipping Address (if same leave blank)
Name ______________________________________                               Name ______________________________________

Address: ____________________________________                             Address _____________________________________

City _______________________________________                              City _______________________________________

State _______________ Zip/Post Code _____________                         State _______________ Zip/Post Code _____________

Country _____________________________________                             Country _____________________________________

								
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