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Add On's: _______________________________________________________________________________
Special Instructions: ________________________________________________________________________________________
_______________________________________________________________________________________
CUSTOMER INFORMATION: (Please print clearly) (FAX to: 530-823-3288)
Name: __________________________ Email: _______________________
Shipping Address:______________________________________
City/State___________________ Zip _________________
Phone No. (_____) _______________________
Visa or MasterCard #: April will call you for your credit card information and to confirm your order within 24-hours.
Security Code (last 3 numbers on back) _______
SKITO PAD: _____________________________________________________________________________________________
Other Tack: _______________________________________________________________________________________________
Easy Care Product Request
After visiting Easy Care and deciding what products you would like to buy, please write a description of what you would like to order below:
________________________________________________________________________________
Dynamite Nutritional Product Request
________________________________________________________________________________
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