Order Form


Please Print Form , Complete, and Return with Check or Money Order Made Payable to:
Keith T. Wright
20 South Main Street, Apt. #135
Glassboro, NJ 08028

_______________Item*___________________________ Price QuantityTOTAL
A Heathy Foods and Spiritual Nutrition Handbook$12.75____________
Are Relationship Problems The Man's Fault$10.95____________
Beat the Sugar Habit-The Sweet Fetish$10.95____________
Fully Figured, Fully Healthy, Fully Loved$11.75____________
Look Good, Feel, Great, Lose Weight Naturally$15.95____________
Weight Loss Tape$5.00____________
Reflections on the Million March$12.95____________
Power and Motion Poster $3.50____________
Sucess and Motivation Poster $3.50____________
Sub-Total$_____
Shipping Charge*+_____
Total for Order$_____

*Shipping & Handling:Please Add $3.00 per Book and $1.50 per Poster


Name ______________________________________________
Address ___________________________________________
City _____________________ State _____ Zip ________
Telephone (____)___________ FAX (____)_____________
E-Mail_____________________________________________

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