Quit Smoking in 7 Days Guaranteed! -QEVR

[Smoke-Away]

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_________________________________________________________________________

                 Enclosed is $49.95 plus $5.00 shipping and handling
                 for each kit ordered. I understand that Smoke-Away
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                 Mail Check or Money Order to:


                            Behavioral Research Center

                                  Dept: 3395

                          5051 Castello Drive, Suite 235

                              Naples, Florida 34103

  NAME ________________________________________________________________

  ADDRESS _____________________________________________________________

  CITY_________________________________ STATE___________ ZIP ____________

                             __MASTERCARD __VISA

  CREDIT CARD NUMBER __________________________________________________

  EXPIRATION DATE ______________________________________________________

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