Order Form

Get Your Miracle Relief FormulaŽ At The Special
Low Price Of Only $29.95 A Jar, Or Less!    

   YES!  Rush me one 4 oz. Jar of Miracle Relief FormulaŽ @ $29.95 plus $4.00 shipping & handling.                  

 YES!  I am Ordering 3 Jars of Miracle Relief FormulaŽ for a total of  $99.85. ($89.95 plus $10.00 shipping),   AND I GET A 4th JAR FREE!  A savings of $29.95.                                                                                               

Mail Orders to: Jerry McGuire, 602 Lucca Dr., Evans, CO 80620
Email: jerrymcguire36@msn.com

  Enclosed is: ($ Total).  I am paying by:  
[]Check  [] Money-Order  

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