Order SPIZ By Mail:

ORDER FORM

Name (Print Out): __________________________________________________________

Address:  _________________________________________________________________

City/State/Zip:  ____________________________________________________________

Phone: (_____) ____________________________

Number of canisters ordered: _______

Flavor: (Please check) ______ Chocolate ______ Vanilla

Shipping information:

$32.00 + $8 shipping and handling = $40.00 per canister (10-12 servings per canister)

$128.00 for a case of 4 + $14 shipping and handling = $142.00 per case

Send Check or Money Order With This Form To:

Longevity Plus

P.O. Box 2466

Fallbrook, CA 92028

(800) 548-4447