• Please provide the following contact information:

  Name
  Organization
  Work Phone
  Home Phone
  FAX
  E-mail
  URL

• Postage/Handling costs are 10% of the total order.  There will be a $2.50 charge for all orders under $50.

  Please provide the following ordering information:

  QTY	DESCRIPTION
  	FM 11 ($42)
  	FM 10 ($42)
  	CSFlex (($50)
  	Allergy Homeopathic Drops ($12.00)
  	Vaccine Detox Homeopathic Drops ($12.00)
  	CSF Drops ($20 per ounce)
  	Milk Thistle Plus ($65)
  	Stableizer ($45)
  	Kool Comfort 78 0z.($52)

  	BILLING
  Name on Card
  Address if different from shipping address
  Master Card or Visa #
  Expiration Date (mm/yr)
  Account Name

  	SHIPPING
  Street Address
  Address (cont.)
  City
  State/Province
  Zip/Postal Code
  Country

Copyright © 1999 [Circle Star Farms]. All rights reserved.
Revised: 06/02/05