Milt Holle's Bargin Barn Order Form 


Relief Pain Spray _____ at $19.95 + $6.00 S & H = ______________

Young Entergetic & Slim _____ at $19.95 + $6.00 S & H =________


Please only send one $6.00 S & H per order.


Total $__________





Send Order To:(Please Print)Name___________________________________________________________

Address________________________________________________________

City, State & Zip______________________________________________

Country________________________________________________________

In case we need to contact you about your order:Phone Number or Email Address__________________________________

Please make your check or money order out to Milton Holle and mail to:

Milton Holle
38860 Bower Rd.
Scio, OH 43988