Order Form

You can print this order form and inlcude it with your mail in order.
We are sorry, we do not accecpt online payments at this time.
For either the Stop Smoking or Fountain of Youth products,
send a S.A.S.E. to:

D.L. Kennell
P.O. Box 1965
Branson, MO 61615

Full Name

Address

City State Zip

Stop Smoking $5.95

Fountain of Youth $5.95	BOTH products for only $7.95
(includes free home remedy for dizzy spells)

Email address or phone number