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EBOOK ORDER FORM

(For product order form, see:  https://www.electricalbody.com/order.htm)

Please print this order form or copy/paste it to
a new message in your email program.

Then simply mail it, email it, or fax it . . .

Mail: Electrical Body, Inc.
5825 Woodside Trl Unit A
Toledo, OH 43623

Email: electricalbody@yahoo.com

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[ ]  I am ordering your new e-book, "How To Heal Your Electrical Body"

Name___________________________________________________

Address________________________________________________

City_____________________ State_______ Zip____________

Telephone Number_____________________________________

Email Address________________________________________

How Did You Find Us? ________________________________

*Please check one of the following payment options:

[ ] I have sent check or money order for $17.95!

[ ] Charge $17.95 to my credit card.

Card Number ________________________________________________

Signature ________________________________________________

Expiration Date ____________

Note: Once your order is received and processed you will receive email
with instructions for downloading the e-book.  Nothing will be shipped.  Thanks for your order.

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These statements have not been evaluated by the Food and Drug Administration. These products are
not intended to diagnose, treat, cure or prevent any medical condition. Testimonials provided here
represent personal experiences and may differ among individuals.

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