Measure of Life
C:\Users\becky.elshoff\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\35ZC4N80\Logo Master 2 (2).png
Product Order Form
DATE: APPOINTMENT DATE:      
PRODUCT QUANTITY AMOUNT   TIME:  
DRINKS PACKS $4/EA BOX $28/EA   PRODUCT QUANTITY AMOUNT
Pineapple & Banana     $- PUDDINGS PACKS $4/EA BOX $28/EA  
Blueberry, Cranberry & Pomegranate     $- Raspberry Jelly     $-
Chocolate Drink Mix     $- Banana Pudding     $-
Vanilla     $- Blueberry Pudding Mix     $-
Cappuccino     $- Butterscotch Pudding     $-
Peach Mango     $- Dark Chocolate Pudding     $-
Pina Colada     $- Milk Chocolate Pudding     $-
Wildberry Yogurt     $- Lemon Pudding     $-
Orange Drink     $- Vanilla Pudding     $-
Pink Lemonade     $- Strawberry Pudding     $-
PREMIX DRINKS SHAKE $5/EA 6 PACK $29.50/EA   VITAMINS    
Vanilla Premix     $- Multi-Vita (60 caps) ($28)   $-
Chocolate Premix     $- Cal-Mag (120 caps) ($24)   $-
Mango Drink ($4.50 each / 8 pack $35.50)     $-     $-
SNACKS PACKS $4/EA BOX $28/EA   Potassium & Calcium ($20)   $-
* White-Choco Cinnamon Bar     $- Natura Omega 3 ($30)   $-
* White Choco Crispy Bar     $- Natura Enzymes ($22)   $-
* Cran-Granata Protein Bar     $- Anti-Oxy ($32)   $-
* Cookies-n-Cream Bar     $- Novi-Lax ($22.50)   $-
* Raspberry Crunch Bar     $- Nordic Natural - ProOmega ($28)   $-
* Lemon Poppy Seed Bar     $- Nordic Natural - ProOmega Jr ($30)   $-
* Vanilla Peanut Bar     $- Novi-Cleanse ($72)   $-
* Peanut Butter Crunch Bar     $-      
* Choco Peanut Butter Bar     $- MISCELLANEOUS    
* Caramel Nut Bar     $- Fresco Gormet Coffee (12 oz - $10)   $-
* Caramel Crunch Bar     $- Sea Salt 2 oz ($2.50)   $-
* Double Chocolate Bar     $- Ideal Protein Water Bottle ($4)   $-
*Chocolate Chip Cookie     $-      
* Peanut Butter Soy Puffs     $- Private Constulation Fee ($50)   $-
* Chocolate Coated Soy Puffs     $- My Ideal Recipes ($30)   $-
* Apple Cinnamon Soy Puffs     $- Healthy Recipes Vol 1 ($15)   $-
* Lemon Soy Puffs     $- Healthy Recipes Vol 2 ($15)   $-
* Soya Nut - Garlic & Onion     $- Healthy Recipes Vol 3 ($15)   $-
* Soya Nut - BBQ     $- Administrative Fees ($150)   $-
* White Cheddar Ridges     $- Shaker ($7)   $-
* Dill Pickel Zippers     $-        
* Salt and Vinegar Ridges     $- TOTAL Items 0  
* BBQ Ridges     $- # Non-axable / Taxable Items 0 0  
* Southwest Cheese Curls     $- Sub Total - Non-taxable / Taxable $- $- $-
BREAKFAST PACKS $4/EA BOX $28/EA   Tax   $-
* Plain Crepe     $-      
* Chocolate Crepe & Muffin     $- TOTAL Items & Amount 0 $-
* Maple Oatmeal     $- NOTE: Journal & order -
Crispy Cereal     $-
Fine Herb & Cheese Omelet     $-
Omlet Mix     $- Only one * item allowed per day Double * * items are only twice per week
LUNCHES OR DINNERS PACKS $4/EA BOX $28/EA  
Chicken Soup     $-
Mushroom Soup     $- C:\Users\becky.elshoff\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\35ZC4N80\Logo Master 2 (2).png
Measure of Life
Leek Soup     $-
Tomato/Basil Soup     $- Office: (402) 371-7171
Chicken NoodleSoup     $- Fax: (402) 371-0906
Broccoli & Cheese Soup     $- www.measureoflife.com
* * Bolognaise Spaghetti     $- order@measureoflife.com
Soy Patty Mix     $-
* Vegetable Chili     $-
Potato Puree     $-