A V A N T G A R D E   H E R B   C O M P A N Y :   O R D E R   F O R M

              PHONE ORDERS TOLL-FREE: (888) 318-8008
              Or use this form to order by fax or mail
              Print form or save it and use word processor


         Name:       ___________________________________________

         Address:    ___________________________________________

         Address2:   ___________________________________________

         City, State Zip: ______________________________________

         Phone:      (___)  ______________________

         Fax:        (___)  ______________________

         E-mail:     ___________________________________________


   Please send me the following products:

   Quantity                                        Price  Amount

      __  Tibetan Energy Tea                       $7.95   _____

      __  Relax & Unwind                           $5.95   _____

      __  Herbal Antibiotic                        $5.95   _____

      __  Jade Screen Anti-Allergy                 $9.75   _____

      __  Immunity                                 $9.75   _____

      __  Green Olive Throat Lozenges              $4.95   _____

      __  Hawthorn Formula                         $9.75   _____

      __  Blood Pressure                          $11.75   _____
	  
      __  Recovery                                $12.75   _____


                                        Subtotal.......... _____

                          Sales tax 8% (CA only).......... _____

                           Shipping and handling.......... _____
                   Priority mail = $ 5 per order
              International mail = $10 per order

                                           TOTAL.......... _____

  Manner of payment:

  [  ] A check to AvantGarde Herb Co. is enclosed.

  [  ] Charge my [ ] MasterCard  or [ ] Visa 

       Account number: __________________________ Expires: ___ / ___

       Signature:  _________________________________________________



            PHONE ORDERS TOLL-FREE: (888) 318-8008

            or FAX the completed form to (831) 426-8989,

            or MAIL it to:

                 AvantGarde Herb Company
                 202 Quarry Lane
                 Santa Cruz, CA 95060