Print this form, then fill in the requested information and fax to: 435-635-9005 or mail it with payment to:
Life Studies, LLC 490 S. 400 W. Hurricane, UT 84737
Name:Phone:
Address:
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Item # Item Name Price Each Qty Extended Cost S & H
           
           
           
           
           
           
           
           
           
Total Cost 
Total S & H  
(Utah residents add 6.35% sales tax. ) 
GRAND TOTAL 
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