Mail Order Form

Advance Order Mail Order Form

To order by mail simply print out and fill in the form below and mail it in with your payment. Sorry, because we've receive so many bad checks in the past, we can no longer accept them.

Your guide will be mailed out on or before Mid August, 2010.

No Checks! - Money Orders or Cash Only - No Checks!

"Avoiding Alzheimer's" - Only $29.95

Cash and Money Orders Only - No Checks!

Name___________________________________________________________________

Address_________________________________________________________________

City ___________________________________________State________Zip__________

Please Print Very Carefully

Ariza Health Research Press, 8803 Brecksville Rd, #7-222, Brecksville, OH 44141

Thank you for your purchase!

If you can't print out this form - just write out your order
on a piece of paper but please print very carefully!