Love Mate Fm Pheromone Mail In/ Fax Form 
Love-Mate Fm Pheromone Attractant Fax / Mail in Form 
 
Print this form for mailing and faxing
VISA/MC/Discover/AmerExp/CASH CHECK/MONEY ORDER
Print this form fax to: Fax# 1- 509-248-8864 

Serving You Since 1997

Instructions for E-Mail orders:  

Fill out order page, go to; Edit, Select All, Copy, Paste to E-Mail Page, 

Now Fill out the rest of the order form. Send to: kenny@kennys-ins.com.






1 bottle of Love-Mate Fmtm..........................$29.95 

2 bottles of Love-Mate Fmtm.........................$56.95 

3 bottles of Love-Mate Fmtm.........................$78.95 


1 bottle of Date-Mate Fmtm..........................$29.95 

2 bottles of Date-Mate Fmtm.........................$56.95 

3 bottles of Date-Mate Fmtm.........................$78.95 




(Mixed order) Love-Mate Fmtm for Women 

1 bottle of Date-Mate Fmtm and 1 bottle of Love-Mate Fmtm..........................$56.95
 
1 bottle of Date-Mate Fmtm and 2 bottles of Love-Mate Fmtm..........................$78.95 

2 bottles of Date-Mate Fmtm and 1 bottle of Love-Mate Fmtm.........................$78.95 


3. Shipping Choices & Charges ( Please choose the one that you would prefer. )

Within the U.S.A. Regular Delivery.....$5.00. 

Outside the U.S.A. Regular Delivery ......$5.00. 

Within the U.S.A. Same Day Rush Shipping U.S.P.O. PRIORITY MAIL ......$10.00.
 
Outside the U.S.A. Rush Delivery anywhere in the world Global Priority when available...$15.00. 

I am enclosing (Please indicate) 

CASH CHECK MONEY ORDER CREDIT CARD/in U.S. Dollars 

ACCOUNT #_____________________________________ 

EXPIRATION DATE__________________ 

Signature_______________________________________ 

Name__________________________________________ 

Address________________________________________ 

City_____________________________State__________Zip Code_____________ 

Email Address_________________________Phone#________________________

Shipping Address if Different from above address

Address________________________________________ 

City_____________________________State__________Zip Code_____________ 

MAIL TO: 
Gunderson Enterprises
732 SUMMITVIEW STE. # 724
Yakima, WA 98902-3032 
Fax# 1-509-248-8864