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Important Notice for Canadian customers only:
Canadian customers can not purchase ANUREX® through Internet. ANUREX® is readily available in pharmacies through-
out Canada.



PRINT & MAIL ORDER FORM

For more information and assistance please contact:
MALITEK INTERNATIONAL INC.

Simple order method:

FILL OUT, PRINT, AND MAIL IN THIS ORDER FORM TO:

J. Pohler
C/O ANUREX®
P.O. BOX 292243 Ft.Lauderdale, Fl. 33329., USA
Tel (305)757-7733

All the prices are in US Dollars

Your Contact Information
Name:
Address:
City:
State:
Zip Code:
E-Mail Address:
Phone Number:
Country:


Payment option:

Select ANUREX® Price in US$
One Anurex set
(including S&H)
$34.90
Two sets  of Anurex add $ 20.00
(including S&H)
$54.90
Anurex Standard 6 pack
($14.95 per unit + $5.95 S&H)
$95.65
Anurex Standard 12 pack
($12.95 per unit +$6.95 S&H)
$162.35


Money Order
Check
Amount enclosed US$
Please make all CHECKS and MONEY ORDERS payable to:
J. Pohler-ANUREX®


***Very Important !!!
In order to speed up your order, click here to send us email, please include your name, address, quantity and the amount of your payment (made out to J. Pohler -Anurex) which you are sending to the above address.

You can contact us directly at (305)757-7733

WE WILL PROCESS YOUR ORDER THE NEXT BUSINESS DAY AFTER BANK CLEARANCE OF YOUR CHEQUE.

(If you do not have a printer, please PRINT on a separate sheet of paper, your name, address, telephone number and the details of your order containing the same information asked for below in this form. Include your check or money order and send to the above address)