Please print this form, fill it out in it's entirety, and send it to the address provided below. Most
orders will be emailed the same day payment arrives.

30 Day Low Carb Diet 'Ketosis Plan' Mail In Order Form

Yes, Scot! I want to take you up on your fantastic offer for 30 Day Low Carb Diet 'Ketosis Plan'.
Please rush me my download copy to the address I provide below. And I understand that I have
a full 365-Day Free Inspection Guarantee so I can review everything and still opt for a refund.

Please include a check or money-order for $37 payable to your name

Name (Please Print)_______________________________________________________

Address _______________________________________________________________

City, State, Zip __________________________________________________________

E-mail _____________________________

PAYMENT OPTIONS:

You have the option to send payment by check or Money Order, MAIL (or we suggest Fed Ex) to:

Your Name
Your address
City state zip

NOTE: (your name) reserves the right to withdraw this offer at any time.