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Parasite Zapper & Colloidal Silver Generator Donation Form

To donate please fill out the form below. Please send the form plus the donation amount to receive your request. Donations may be either cash, check or money order. Send donations to Michael Barker, general delivery, c/o Box 142, Santa Clara, Utah [ 84765 ]

Fields in red are required to process form.

	First/Last Name:
	Address:
	City/State/Zip:
	Phone:
	Email:

I would like to request the following items:

Qty

Item

Parasite Zapper/Colloidal Silver Generator
Suggested donation for the unit is 185.00 dollars.
Includes: Padded carrying case,12 VDC wall transformer, 4 nines, fine silver electrodes, and complete directions.

2 Ounce bottle with atomizer sprayer
Suggested donation is 3.00 dollars.

2 silver electrodes with banana plugs
Suggested donation is 15.00 dollars.

Cigarette lighter plug
Suggested donation is 10.00 dollars.

Solar module
Suggested donation is 50.00 dollars.

Parasite Zapper/Colloidal Silver Generator
with above Accessories
Suggested donation for complete package is 245.00 dollars.

Includes 7.00 dollars for shipping and handling.

For more info: mikebarker@lifedevice.com