Order Form To Order: Print this form, enclose check or moneyorder and mail to: Herbal Aids P.O. Box 516 Garden Grove, CA 92842-0516 OR if paying by C.O.D. Fax it to me at: (714) 530-5029

QTY. Order Number Vitamins & Minerals Size Price Each Total Price   553 Beta Carotene in Soyoil 100/pkg $ 5.50     557 Calcium Soft Gels 100/pkg $ 8.50     568 Choromium Capsules 200mg 100/pkg $ 7.50     10171 DHEA Capsules 60/pkg $ 10.95     10076 Gingseng w/ Vitamin E Tablets 30/pkg $ 5.24     679 Ginkgo Biloba Capsules 60mg 50/pkg $ 10.00     537 L-Lysine Capsules w/B6 100/pkg $ 4.85     698 Melatonin Capsules 3mg 60/pkg $ 9.00     10078 Niacin Tablets 500mg 100/pkg $ 6.00     281 Potassium Tablets 100/pkg $ 4.62     10068 Shark Cartilage 90/pkg $ 20.00     750 Vitamine C Chewable 500mg 60/pkg $ 4.24     178 Vitamin C w/Rosehips 1000mg 100/pkg $ 6.50     202 Vitamine E 400 IU 50/pkg $ 7.00

QTY. Order Number Herbs Size Price Each Total Price   10076 Ginseng w/Vitamin E 30/pkg $ 5.24     10071 Ginkgo Biloba 30/pkg $ 4.50     10037 Yohimbe Capsules 30/pkg $ 12.75

QTY. Order Number Misc. Supplemental Size Price Each Total Price     Chinese Addiction Herbal Formula ??/pkg $ ??.??     09432 Highland Mulsified Beverage 2 - 100ml bottles/pkg $ ??.??     73410 Bloom Life 1 gallon $ 32.00

Recreational Products QTY. Model # Model Name Shipping Weight Price Each Total Price   #68314 Challenger 500 37.7 lbs. $ 93.99     #68364 Challenger 400 24.0 lbs. $ 54.25     #68344 Challenger 300 14.5 lbs. $ 37.49     #68334 Challenger 200 9.5 lbs. $ 26.49     #68625 Motor Mount Kit 7.75 lbs. $ 28.95     #69628 Aluminum Oars 2.5 lbs. $ 11.62/pr.     #58556 101 Dalmations - Pongo Ride-On 2.4 lbs. $ 8.50     #58423 101 Dalmations - Inflatable Pool 2.75 lbs. $ 9.79     #59196 Big Canvas Surf Riders 2.7 lbs. $ 11.29     #68209 River Rat - Tube Raft 3.4 lbs. $ 11.29     #68204 Water Ski-Tube 6.2 lbs. $ 20.29

Total Item Quantity Total Weight Total $ of 4 forms       Shipping Charge (See chart below)   Handling Charge $ 3.00 Subtotal   CA Sales Tax 7.75%   Total Amount Due

Shipping Charges Weight: Cost: Weight: Cost: 1 - 5 lbs $ 4.80 6 - 10 lbs $ 6.55 11 - 15 lbs $ 9.05 16 - 20 lbs $ 11.50 21 - 40 lbs $ 17.50 41 - 60 lbs $ 27.50 61 - 80 lbs $ 30.39 81 - 100 lbs $ 32.24 Over 100 lbs Call for charges $ 150.00 or more Freight Allowed

Payment By: Check: ______ Money Order: ______ C.O.D.: _______ First Name: ____________________ Last Name: _________________________ Address: __________________________________________ City: ________________________ State: _____ Zip: ____________ Phone #: _________________ E-Mail Address: _________________________

To Order: Print this form, enclose check or money order and mail it to: Herbal Aids P.O. Box 516 Garden Grove, CA 92842-0516 OR if paying by C.O.D. Fax it to me at: (714) 530-5029

E-Mail: lazog@naturalherbs.com