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|   ___                                                                                                      | 
|  |___|  Baby Gard unit (24.95) + 3.50 (shipping & handling)                                                |
|                                                                                                            |
|   ___           ___                                                                                        |
|  |___|  Check  |___|  Money Order                                                                          |
|                                                                                                            |    
|  Total Enclosed $_________________________________________________________________________                 | 
|                                                                                                            |                                                                                                            |
|  Print Name ______________________________________________________________________________                 |
|                                                                                                            |
|  Address ______________________________________________Apt. #_____________________________                 |
|                                                                                                            |
|  City/State/Zip___________________________________________________________________________                 |
|													     |	
|  Mail to: B. H. O. Distributors									     |
|	    1700 28th St. S. W.										     |	
|	    Grand Rapids, MI 49509									     |	
|	    (616) 530-0817										     |	
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