Please print this form, enter the required information and mail to:
Austin Research Institute
Order Dept # HGH
P.O. Box 522
Hampstead, MD 21074
USA
ORDER SIZE OPTIONS
The following are pricing options for HGH 191™ (please circle one):
Only $ 95.95 for 1 bottle ($88.00 + $7.95 S&H)
EQUALS $95.95 PER BOTTLE
Only $183.95 for 3 bottles (BUY 2, GET 1 FREE + $7.95 S&H)
EQUALS $61.32 PER BOTTLE
Only $264.00 for 5 bottles (BUY 3, GET 2 FREE + FREE S&H)
EQUALS $52.80 PER BOTTLE
Only $480.00 for 12 bottles (BUY 6, GET 6 FREE + FREE S&H) - OUR BEST VALUE!
EQUALS $40.00 PER BOTTLE
Maryland residents please add 6% sales tax. All prices are in U.S. Dollars.
Each bottle of HGH 191™ contains a 21 day supply to be cycled over 28 days.
PAYMENT OPTIONS
We accept the following forms of payment (U.S. funds only):
cash
money orders
cashier's checks
Note: We do not accept personal checks or COD's.
Please make your money order payable to: Austin Research Institute
CUSTOMER SHIPPING INFORMATION
FULL NAME: ____________________________________________________
STREET ADDRESS: _______________________________________________
CITY, STATE, ZIP: _______________________________________________
Note: Your daytime telephone number is needed in the event the carrier has to contact you regarding delivery.
Your email address is needed in the event that we must contact you regarding your order. All of your information will remain
completely confidential and will not be sold or given to anyone. Maryland residents please add 6% sales tax. All prices are in U.S. Dollars.
AGE VERIFICATION
I hereby certify that I am at least 18 years of age.