PRINT OUT THIS FORM, fill in appropriate areas, and Telephone, FAX or mail to:

Retail Direct - PIN #117054 Customer Order Form

DWG  INTERNATIONAL P.O. Box 98867 Las Vegas, NV 89193-8867 CALL TOLL-FREE 1-800-820-6893 FAX to (702) 262-5550

DATE:

FOR OFFICE USE:

CUSTOMER INFORMATION		SHIP TO INFORMATION (If Different)
ACCT #	Distributor PIN # 117054	( ) Check here to use CUSTOMER INFORMATION as SHIP TO
NAME:		NAME:
ADDRESS:		ADDRESS:
CITY:		CITY:
STATE:	ZIP:	STATE/ZIP:
PHONE:		PHONE:

ITEM CODE	D E S C R I P T I O N	QTY	PRICE EACH	TOTAL PRICE
1011	DRI WASH 'n GUARDTM for Auto - 32 oz.  (Includes 8 oz. Pump Bottle)	.	$38.95	.
1611	DRI WASH 'n GUARDTM Ultra-Ion - 16 oz.  (Includes 8 oz. Pump Bottle)	.	$21.95	.
1021	DRI WASH 'n GUARDTM for Auto - 64 oz. (Excludes 8 oz. Pump Bottle -see #2002 to purchase)	.	$71.95	.
1501	DWG Power Blast - 10 oz		$19.95
3441	Detailers Pack - 1 Ultra-IonTM, Leather, Fabric, Metal, Tire, & OxyGone		$100.00
1531	NEW DWG Power Blast  for the Home- 10 oz		$19.95
1025	DWG Upholstery, Fabric & Carpet Treatment -16 oz.	.	$10.95	.
1050	DWG Leather & Vinyl Treatment -- 16 oz.	.	$10.95	.
1060	DWG Premium Metal Polish -- 12 oz.	.	$14.95	.
1070	DWG All-Weather Tire Treatment -- 16 oz.	.	$13.95	.
1090	DWG PolyGuard-1™ Oil Treatment -- 8 oz.	.	$16.95	.
1150	DWG OxyGone-1™ -- 8 oz.	.	$12.95	.
1160	DWG Dust B' Gone-1™ -- 8 oz.	.	$9.95	.
2002	DWG Waterless Car Wash Empty  8 oz. AIRosols	.	$4.00	.
2230	BodyPruf Total Body Care Formula - 16 oz.	.	$17.95	.

PAYMENT INFORMATION	Product SubTotal Shipping & Handling 7% of Product (Total or $7.95 whichever is greater) Sales Tax (NV, MN and KS only) Enter the tax at your local tax rate TOTAL
( ) Check # _________      ( ) Money Order ( ) ______________________ ( ) Charge my credit card: ( ) VISA ( ) Master Card ( ) AMEX ( ) Discover
Credit Card # __________________________
Exp. Date: _____/_____ Signature: _X________________________
Card Holder: __________________________