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ORDER FORM
(Please Print out for Fax
or Mail Order Only)
Yes, I would like to become
a SoyClub member and place an order now as the following.
First Name_________________M.I________Last
Name______________
Street Address:_______________________________________________
City:__________________________State:______ Zip___________
Home Phone #:________________E-mail:___________________
Fax # if available:_______________________
SoyMilker Unit Price $109.95 x _____________how many
Shipping and Handling $10.95
x ___________________
CA Residents add 8.25% sales tax: $ ________________
Total $ ______________
Payment Method: Visa 
Mastercard
A.E.
Discover
Check
Card No:
Exp. Date:
Signature:___________________________Date:_______________
Should you like to pay
by check or money order, please mail this form along
with your check or money order to:
SoyClub, Order Processing Dept.
5230 Pacific Concourse Dr.
Suite 200
Los Angeles, CA 90045-6256