Print - Fill Out - Mail or, Fax in your order

Fax to: 1-800-957-1527 Or, Mail it to:
FMG C/O WeightLossGuide.com
40 E. Main Street,   Dept. #357,
Newark, DE 19711   (For fast delivery Click Here to return to previous page. Click the "Add To Cart" button).
Name: _________________________       
Email: _________________________
Address: _________________________
(Same Day Mailing by US Postal Service - - PO Boxes OK)
City: _________________________
State: _________________________
Country: _________________________
Zip: _________________________
Phone: (____) ______ - ____________
MeltRx™ 24 Ultra:_____ @ $54.00= $ __________ Or, (3-Pack bundle): $39.95 per bottle
The Ultimate Success Kit:_____ @ $$97.95= $ __________ Or, (2-Pack bundle): $84.45 per kit
Hoodoba® Pure 400MG:_____ @ $54.00= $ __________ Or, (3-Pack bundle): $47.95 per bottle
Hoodoba® Pure 750MG:_____ @ $59.95= $ __________ Or, (3-Pack bundle): $49.95 per bottle
Hoodoba®Hunger Block:_____ @ $54.00= $ __________ Or, (3-Pack bundle): $47.95 per bottle
Hoodoba® HB Combo:_____ @ $92.95= $ __________ Or, (3-Pack bundle): $87.95 per bottle
NutriMelt Shakes:_____ @ $29.95= $ __________ Chocolate: Or, (4-Box bargain): $19.95 per box
NutriMelt Shakes:_____ @ $29.95= $ __________ Vanilla: Or, (4-Box bargain): $19.95 per box
Protein Food Bars:_____ @ $29.95= $ __________ S'Mores: 1 Box (15 Bars)
Protein Food Bars:_____ @ $29.95= $ __________ Raspberry: 1 Box (15 Bars)
LipoRidAM:_____ @ $29.95= $ __________ Or, (3-Pack bundle): $23.95 per bottle
LipoRidPM:_____ @ $29.95= $ __________ Or, (3-Pack bundle): $23.95 per bottle
TrapRx™ 24 Ultra:_____ @ $29.95= $ __________ Or, (3-Pack bundle): $23.95 per bottle
PantoSure™:_____ @ $15.95= $ __________ Or, (3-Pack bundle): $13.95 per bottle
Lift™:_____ @ $23.95= $ __________ Or, (3-Pack bundle): $19.95 per bottle
Cell-U-Melt:_____ @ $23.95= $ __________ Or, (3-Pack bundle): $19.95 per bottle
LipoRidAM:_____ @ $29.95= $ __________ Or, (3-Pack bundle): $23.95 per bottle
Tonalin CLA (120 ct.):_____ @ $29.95= $ __________ Or, (3-Pack bundle): $25.95 per bottle
System I:_____ @ $69.95= $ __________ Drink: Chocolate   Vanilla   Both
System II:_____ @ $99.95= $ __________ Drink: Chocolate   Vanilla   Both
System III:_____ @ $179.95= $ __________ Drink: Chocolate   Vanilla   Both
System Gold:_____ @ $249.95= $ __________ Drink: Chocolate   Vanilla   Both
The Slenderizer:_____ @ $39.95= $ __________ Or, (3-Pack bundle): $29.95 per bottle
Organic Flax Seed:_____ @ $8.95= $ __________ Or, (3-Pack bundle): $5.95 per bottle
Organic Flax Seed:_____ @ $17.95= $ __________ Or, (3-Pack bundle): $14.95 per bottle
Viatril:_____ @ $21.95= $ __________ Or, Buy 2 Get 1 Free
Viadure:_____ @ $21.95= $ __________ Or, Buy 2 Get 1 Free
 
SUB TOTAL= $ __________
Shipping & Handling= $ __________
TOTAL= $ __________

US: $7.95; $19.95 2-Day Express; $29.95 Next Day Delivery; Canada, Alaska & Hawaii: Ad $10 to US rate; UK, Europe and Austrailia $29.95.

(  ) I am enclosing a check or money order for $____________
Please note: If you are paying by check you must make it payable to FMG, LLC
and mail it in. We do not accept checks by fax.

(  ) I want to charge this purchase to my Credit Card

Credit Card (check one):

VISA       MasterCard      American Express      Discover

Card Number: _________________________

Expiry Date: _________        Signature: _________________________

I authorize FMG, LLC to charge $____________ to my credit card for the purchase (and shipment) of the above products.

Note: If you are using a credit card charges will show up on your statement under Strictly Health, LLC which is our parent company. All orders will be shipped within 48 hours of receipt. Orders accompanied by checks will be held until cleared.

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