Order Form

Get Your Miracle Relief FormulaŽ At The Special
Low Price Of Only $19.95 A Jar, Or Less!    

YES!  Rush me one 4 oz. Jar of Miracle Relief FormulaŽ @ $19.95 plus $4.00 shipping & handling.                   

YES!  I am Ordering 3 Jars of Miracle Relief FormulaŽ for a total of  $59.85, plus $8.00 shipping AND I GET A 4th JAR FREE!  A savings of $19.95.                                                                                               

YES! I am ordering 8 jars of Miracle Relief FormulaŽ for a total of $158.60, plus $15.00 shipping & handling, and receive 4 jars FREE! (A TOTAL OF ONE DOZEN!) A savings of $79.80.

                  Mail Orders to: David Sager, 10103 Bartee, Arleta, CA 91331-4514
        Enclosed is: ($ Total).  I am paying by:[]Check  [] Money-Order 

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