Fluoride, Teeth & The Atomic Bomb
Order Form

YES, I want the book Fluoride, Teeth & The Atomic Bomb! Please send them to the mailing location filled in below. Enclosed please find a $20.00 + $2. S&H ($22. Total) Cash or Money Order with the "Pay To" line left Blank.

Name:__________________________________________________

Mailing location: _______________________________________________

City:__________________________ State:_____________________________

Postal number: ___________

Print this form out, fill in the blanks, enclose $20.00 +$2 S&H ($22. Total) Cash or Money Order
("Pay To" BLANK) and send to:

Fluoride
c/o 6500 Shadow Glen.
Eagle Point, Oregon.
near 97524