Doctor Millers Tea 
            P.O. Box 10242 
            Jackson, TN 38308 
              
            NAME _________________________________ COMPANY NAME
              ___________________________________ 
              
              
            SHIPPING ADDRESS: 
              
            STREET No. & NAME __________________________________ APT OR SUITE NUMBER _____________ 
              
            CITY, STATE & ZIP
              _________________________________________________________________________ 
              
            TELEPHONE NUMBER ________________________ E-MAIL _______________________________________ 
              
              
            # PACKS               ITEM                                                                                                                                     TOTAL
              COST 
              
            ________             HOLY TEA 
              (8 tea bags per package) @ $28.99 each                                                ____________ 
              
            ________             MIRACLE
              TEA  (8 tea bags per package) @ $28.99 each                                        ____________ 
              
            ________             YOUTHIN 
              (20 four-pill packs) @ $44.99 each                                                            ____________ 
              
            ________             YOUthin PLAN
              (120 pills & 8 tea bags) @ $62.99 each                                             ____________ 
              
            ________             YOUthin ULTRA 
              (180 pills & 8 tea bags) @ $72.99 each                                       ____________ 
              
            ________             YOUthin NV  (180 pills & 8 tea bags) @ $72.99 each                                               ____________ 
              
            ________             BE FREE
              (8 capsules & 4 tea bags) @ $62.99                                                              ____________ 
              
            ________             LUXORIA
              (30 capsules) @ $44.99                                                                                 ____________ 
              
            SUB
              TOTAL  $ ____________  S&H
              ($7.99 UNDER 10 ITEMS or $11.99 10 ITEMS OR MORE)  $ __________ 
              
            TOTAL
            OF ORDER $ ____________ See Bulk Price List for discounts. 
              
            Thank you for your order!  We very much
              appreciate your business. 
              
            Please make checks or Money Orders payable to DoctorMillersTea. 
            Allow 7-10 days for personal checks to clear before order is
              shipped.             |