SECURE ORDER FORM

$33.95* $33.95* $33.95* $33.95* $33.95* $33.95

Natural Connections

Metabolife 356 Distributing by Natural Connections, Inc. Metabolife 356 Dietary Supplement

*Secure order Form*
For Secure Ordering Click Here

**Customer Information**
Name:		Address:
City:		State:
Zip:		Phone:
E-Mail:	*Complete Address ie. jdoe@domain.com*	Fax:

NOTE:All orders of (2) two or more
bottles are shipped Priorty Mail

**Order Information**
Item	Price	Quantity	Sub-TOTAL
Sample Pack (4 tablets)	$1.75
Metabolife 356 ™(90 Caplets)	$33.95
		Sub-TOTAL
Select one:	Inside the US (FREE Shipping) Outside the US
		Handling Fee 4.5%
		TOTAL

**Credit or Checking Information**
***ALL CREDIT CARD ORDERS MUST COMPLETE AVS SECTION***
*AVS=Address Verification System
***The Correct billing Address for the credit card***
***that you are using must be provided for processing***
***It is very important that this information be correct!***
	Method of Payment
Credit-Card	Information*
Card Type:
Card #:		Expiration Date: (mm/yy)
***AVS	Information
Billing Addr:		Billing City:
Billing State:		Billing ZIP:

Checking	Information
Bank Name:		Bank Address:
Bank City:		Bank State:
Bank Zip:		Bank Phone:
Acct #:		Routing #:
Fraction:		Check #:

Call TOLL FREE 1-888-822-DIET (3438) and Order Yours Today! If you wish to mail in a check please send $33.95 plus $1.53 Handling Fee per bottle TO: Natural Connections, Inc. 301 West Harford Street Milford PA 18337 Metabolife, The Ultimate Dietary Product this Century sales@naturalconnections.com Copyright © 1999 Natural Connections, Inc., 1-800-897-7341 Metabolife 356 ™ is a trademark of Metabolife International, Inc.™ Metabolife Approval Code: Pending

Natural Connection, Inc. All Rights Reserved