SORRY, WE ARE NOT ACCEPTING NEW DISTRIBUTORS AT THIS TIME! Please print this order form to mail or fax your order. You can also make purchases with your credit card, by printing this form to mail or fax order. Ship To: (Please Print) Name:______________________________________________________________________ Company:__________________________________________________________________ Address:___________________________________________________________________ City:_____________________________State/Province___________Zip_____________ Telephone:________________________ (in case of a question about your order) Your E-Mail Address:________________________________ Thanks for your order! Item # Description Quantity Price Item # 033 Liquid Magnet |______|______| SUBTOTAL |______| Texas Orders Add 6% Sales Tax |______| P.S. Checks Must be From American Banks Only TOTAL |______| and money orders payable in U.S. dollars CREDIT CARD ORDERS To charge your order, please check-> __Visa __MasterCard __American Express __Discover Credit Card Number_______________________________Expiration Date_____/_____ Card Holder's Name (please print)__________________________________________ Card Holder's Signature____________________________________________________ Mail this order form with your check or M.O. to: Gemini Publishing Co., 3102 W. Bay Area Blvd., Suite 707, Friendswood, TX 77546. Thanks for your order.