Print this form, write in your order, then mail or fax

Lowcarb Pantry Order Form

http://www.lowcarb.com.au Lowcarb Pantry - a division of Pain Busters Clinic

Item	price	number	amount
Lowcarb Mega MuffinMix - 450 gram - make 2 dozen muffins Delivered FREE to any major city/suburb in Australia. SPECIAL - BUY ONE, GET ONE FREE!	$12.00
Lowcarb Mega-Muffin mix - 900 gram – makes 4 dozen muffins	$16.65
SPECIAL : Order 3x 900g muffin mix & get it DELIVERED FREE Australia wide	$49.95

Dr Bernstein’s Diabetes Solution: A complete guide to normal blood sugars (Hardcover)	$60.39

Zen-Chi machine ‘relaxerciser’	$298.00
Optional Lamb’s wool cover for the ankle rest	$27.50

PLUS ‘PACK AND POST’ (select which applies)
Perth Metro area orders only, up to 20 Kg.	$5.95
other orders per 3 kg of order (except ZenChi – see below )	$7.50
Zen-Chi machine postage	$15.00
Lambs wool cover postage, if posted separately	$5.00
TOTAL PRICE FOR ORDER include post where applicable

Yes I would like to purchase the products I have marked above Please deliver to….

NAME………………………………………………………………………………

ADDRESS……………………………………………………………………………

……………………………………………………….................................................

Phone………………………………………………..

Method of payment:

cheque / money order for the total made payable to Lowcarb Pantry

or charge my credit card

Bankcard , MasterCard , Visa , Card No _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Card holders name……………………………………………………….

Expiry date………………Signature……………………………………………..

Post to Lowcarb Pantry, PO Box 1251 East Victoria Park WA 6101

or Fax (08) 9470 4471

Please allow 14 days for delivery