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F.I. International

ORDER FORM

Healthy Meal Menu Planner©™

Product List:

$40.00 for Healthy Meal Menu Planner - Standard©™. Proven performance and reliablity.

____x @ $40.00 = ________

$40.00 for Now About Eating!©™. Proven Addiction Recovery version.

____x @ $40.00 = ________

$50.00 for Healthy Meal Menu Planner - Professional©™. Proven Professional in all respects.

____x @ $50.00 = ________

Total from above $___________

-------CA residents add 7.75% tax $___________

$10.00 Shipping/handling ea.(USA) $___________ {$25.00 outside the USA}

TOTAL Amount due $______.____

Name __________________________ _________________________

Printed name

Signature________________________________orders not shipped w/o signature

Address: Street_________________________ Bldg.____________

City ________________________ State_____, Zip______-____

Contact Phone Number: (_____) ___--______