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Mail This Order Form — Mail this order to: Don Porter
2178 Bruce Rd., Suite 209
Delaware, OH 43015

Please include (preferably) a U.S. Postal money order made out to Don Porter
(ships within 3 days) or a check (ships within 4 weeks).
I ship US Priority mail included in the prices below.
I accept ITEX and IMS barter checks.
Questions? Call toll-free 1-877-280-5473

Name:_________________________

Street Address:_____________________________

City:_____________________  State:______ Zip:_______

Phone:_______________________        Date:___________________

                                            

PRICES FOR MY ADJUSTABLE MAGNETIC MATTRESS PADS

For best results, use a pad for each person sleeping on your bed.
Example; 2 pads for a King Size mattress sleeping 2 persons
 
DESCRIPTION AMOUNT TOTAL

Retail List prices:
1 Pad: $360.00
 


No. of Pads _______
$ _________
Call 1-877-280-5473 for Special Prices when ordering 2 or more pads No. of Pads  ______ $ _________

GRAND TOTAL:

$ _________
 I also make back pads, shoe inserts, pads for auto; truck, furniture seats and  under pet beds. Call 1-877-280-5473 for prices.
 


MY PADS make thoughtful gifts. Our mattress pads are warranted against defective materials. Abuse will not be considered a defect of material.
 

If the user of this product has a pacemaker, an implanted electro-medical device or if pregnant, consult a medical Doctor before use.
Computer disks, videotapes, credit cards or similar magnetic products may be affected by close proximity to this product.