Sonic Health Care HEALING PROGRAM ORDER FORM PROGRAM NAME UNIT PRICE QUANTITY ITEM TOTAL ________________________________________ __________ ________ __________ ________________________________________ __________ ________ __________ ________________________________________ __________ ________ __________ ________________________________________ __________ ________ __________ ________________________________________ __________ ________ __________ ________________________________________ __________ ________ __________ ________________________________________ __________ ________ __________ ________________________________________ __________ ________ __________ SUBTOTAL __________ 7% GST (Canada only) __________ Shipping ____$8.00_ TOTAL __________ NAME __________________________________________________________________ ADDRESS __________________________________________________________________ CITY _________________________________ PROV/STATE ___________________ COUNTRY _________________________________ POSTAL CODE ___________________ PHONE/FAX/EMAIL __________________________________________________________ VISA # ______________________________ EXPIRY DATE ___________ NAME AS IT APPEARS ON CARD _______________________________________________ SIGNATURE ______________________________________________________ Make cheques payable to GLOBAL HARMONY HEALTH Corp. and send your order to: Global Harmony Health Corp. 1269 Begley Kelowna, BC V1P 1K8 Canada Thank you for your order. Please allow four weeks for delivery or instantly download through the internet.