Fax or Mail Form
Please print this form and fax with credit card information or send the completed form with a check or credit card information to:
To order on-line via a secure order form
CLICK HERE
and enter Sam Bridgers & Distributor Number 24066 as your sponsor.
Vitality For Life
4422 Burgundy Drive
Louisville, KY 40299-4070

1-877-532-4180 FAX 1-502-266-9185


PRICE REDUCTION!!!
NOW AVAILABLE IN CAPSULES!
DO NOT PAY $125!
 SUGGESTED RETAIL PRICE IS $119.00.
DISTRIBUTORS, "PAY $19.00 FOR THE MOST INFORMATIVE
AUDIO DISTRIBUTOR KIT AND
BUY PRO-Symbio PLUS FOR $79.00 OR LESS!"
Attention: Order Department

There are two ways to purchase our products.  Retail customers, please use the first form below.  If you would like to save up to 40%, beginning with your very first order, you may sign up as a wholesale buyer/distributor.  Becoming a distributor is a very simple process.   You validate your distributorship by placing your first initial wholesale order which will include a one-time $19.00 distributor kit. (click here)  That's all there is to it!  If you would like to take advantage of our discounted pricing, please complete your order using the second order form below.

Terms & Conditions:

  • No health claims are made on "Feel Young" products.
  • All orders shipped pre-paid by check, money order, VISA, MC, Amex.

RETAIL ORDER FORM
Product Name & Description Unit
Price		 Qty

Total
Cost
($US)

PRO-Symbio PLUS (1 month supply)

$125.00

PRO-Symbio PLUS - 3 Pack ($89 each)

$267.00

PRO-Symbio PLUS - 6 Pack ($79 each)

 $474.00

Secretagogue-HGH (New & Improved)

 $129.00

LifeMinerals (1 month supply)

 $35.00

ABle-Body (1 month supply)

$39.00

In-Balance for Women (2 oz jar)

 $35.00

Bod-E-Smart (15 servings)

 $45.00

ProLife w/ Lycopene (1 month supply)

 $49.00

Ultra Trim+ (1 month supply)

 $35.00

Zeal for Life (1 month supply)

 $39.00

Quit for Life (complete 3-part program)

 $149.00

BodyClenz (1 month supply)

 $49.00

Parasite Clenz (90 capsules)

 $20.00

ImmunoDefenz-19 (1 month supply)

 $49.00

Life Caffe' (24 servings)

 $10.00
Subtotal Amount ($US) for This Order

Sales Tax 6.9% (AZ residents)

Shipping 

48 Contiguous States 5% ($5 min, $75 max)
HI, AK, PR, CAN, MEX - US$15.00
Western Europe - US$30.00   Other - US$35.00

TOTAL AMOUNT ($US) FOR THIS ORDER

WHOLESALE ORDER FORM
Product Name & Description Unit
Price		 Qty

Total
Cost
($US)

PRO-Symbio PLUS (1 month supply)

$79.00

PRO-Symbio PLUS - 3 Pack ($69 each)

$207.00

PRO-Symbio PLUS - 6 Pack ($59 each)

 $354.00

Secretagogue-HGH (New & Improved)

 $89.00

LifeMinerals (1 month supply)

 $20.00

ABle-Body (1 month supply)

 $29.00

In-Balance for Women (2 oz jar)

 $22.00

Bod-E-Smart (15 servings)

 $39.00

ProLife w/ Lycopene (1 month supply)

 $39.00

Ultra Trim+ (1 month supply)

 $25.00

Zeal for Life (1 month supply)

 $25.00

Quit for Life (complete 3-part program)

 $79.00

BodyClenz (1 month supply)

 $36.00

Parasite Clenz (90 capsules)

 $14.00

ImmunoDefenz-19 (1 month supply)

 $39.00

Life Caffe' (24 servings)

 $24.00

Distributor Kit (first order only)

 $19.00  
Subtotal Amount ($US) for This Order

Sales Tax 6.9% (AZ residents)

Shipping 

48 Contiguous States 5% ($5 min, $75 max)
HI, AK, PR, CAN, MEX - US$15.00
Western Europe - US$30.00   Other - US$35.00

TOTAL AMOUNT ($US) FOR THIS ORDER

Licensed Medical Professionals, please call for pricing.

For ordering questions, or to inquire about other products
please call TOLL FREE 1-877-532-4180

VISA
MASTERCARD
 AMERICAN EXPRESS
 Discover

ACCOUNT NUMBER:
EXPIRATION   DATE:
NAME AS PRINTED ON CARD:

SHIPPING INFORMATION

*Name:
*Address (No PO Boxes)
*City:
*Province/State:
*Country:
*Postal/Zip Code:
Soc Security/ID Number
(New Distributors Only)

*Day Phone:
*Eve Phone:
Best Time to Call:
**Fax:
**E-mail Address 
 *Orders without these items cannot be processed.

**Please include these items to receive monthly news updates
Questions or Comments?

For ordering questions, or to inquire about other products

please call TOLL FREE 1-877-532-4180
By submitting the above information, I certify that all above information is true and correct.

These are products that are selected by a group of knowledgeable, well educated individuals, including medical professionals, that believe in the benefits of these products but individual results may vary.
E-mail Your Questions

Vitality For Life
Distributor Number 24066
Louisville, Kentucky
1-877-532-4180

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