Snail Mail / E-Mail Order Form

Use this form to order via snail mail or e-mail.

Print this form and mail to:

Tierra Mega-Nutrients Inc.
223 N. Guadalupe St. #285
Santa Fe, NM 87501

Copy and paste this form and send an e-mail mail to:

gh3life@earthlink.net

(Sales tax will be added to all orders received from New Mexico)

 __________________________________________________________________________________________
| Code | Description                | 1 Unit  | 3 Units | 6 Units | 12 Units | Qty | Total |
|______|____________________________|_________|_________|_________|__________|_____|_______|
| 100  | Original-Formula GH3       |  $24.95 |  $66.00 | $114.00 | $216.00  |     |       |
|      | (Enteric-coated) 60 tabs   |         |         |         |          |     |       |
|______|____________________________|_________|_________|_________|__________|_____|_______|
| 800  | GH3 Facial Milk - Daytime  |  $39.95 |  $99.00 | $180.00 | $360.00  |     |       |
|      | 1 oz. (6-8 wks supply)     |         |         |         |          |     |       |
|______|____________________________|_________|_________|_________|__________|_____|_______|
| 400  | DHEA 100 caps, 25 mg. ea.  |  $14.00 |  $42.00 |  $84.00 | $174.00  |     |       |
|      | Pure Pharmaceutical DHEA   |         |         |         |          |     |       |
|______|____________________________|_________|_________|_________|__________|_____|_______|
| 410  | DHEA 100 caps, 10 mg. ea.  |  $12.00 |  $36.00 |  $72.00 | $150.00  |     |       |
|      | micronized                 |         |         |         |          |     |       |
|______|____________________________|_________|_________|_________|__________|_____|_______|
| 450  | Pregnenolone 90 caps/10mg  |  $16.00 |  $48.00 |  $90.00 | $168.00  |     |       |
|______|____________________________|_________|_________|_________|__________|_____|_______|
| 450  | Pregnenolone 150 caps/30mg |  $39.95 | $119.85 | $228.00 | $432.00  |     |       |
|______|____________________________|_________|_________|_________|__________|_____|_______|
| 625  | 5-Hydroxy-L-Tryptophan     |  $19.95 |  $59.85 | $108.00 | $204.00  |     |       |
|      | 30 caps, 50 mg             |         |         |         |          |     |       |
|______|____________________________|_________|_________|_________|__________|_____|_______|
| 625  | 5-Hydroxy-L-Tryptophan     |  $69.50 | $209.85 | $384.00 | $720.00  |     |       |
|      | 120 caps, 50 mg            |         |         |         |          |     |       |
|______|____________________________|_________|_________|_________|__________|_____|_______|
| 475  | TMG - 15   500mg/120tabs   |  $16.00 |  $48.00 |  $90.00 | $168.00  |     |       |
|______|____________________________|_________|_________|_________|__________|_____|_______|
                                                                        |          |       |
                                                                        | Subtotal |       | 
                                                                        |__________|_______|
                                                                        |          |       |
                                                                        | Shipping     $6  |
                                                                        |__________|_______|
                                                                        |          |       |
                                                                        |  Total   |       |
                                                                        |__________|_______|
Credit Card Information (snail mail orders)

Master Card __________________________________________  Expiration _________

       VISA __________________________________________  Expiration _________


  Full Name __________________________________________

    Address __________________________________________

       City __________________ State____ Zip _________

    Country __________________________________________
PLEASE ALLOW 14 DAYS for your order to be processed and shipped. Although most orders are shipped within 3-5 days of being received, there are occasional computer slowdowns in credit card processing, or shortages of product from the manufacturer, that add days to the speedy handling of your order. Please do not call or write us until at least 14 days has gone by. We do try to confirm the receipt of most orders by phone or email within 48 hours.
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