Testimonial Form

For my website, catalog, and other promotional pieces, I am continually seeking testimonials of my customers' personal experiences with my products. I will be very grateful if you can oblige by giving a brief account of your experience with one or more of my products.

Please print and fill out the following form and return it ASAP. Thanks! HSB
FAX: 530-550-7537 MAIL: P.O. Box 4275, Truckee, CA 96160

NAME ______________________________________________   PHONE ________________________________

ADDRESS   _________________________________________________________________________________

HOMETOWN   ______________________________   OCCUPATION   _________________________________

Brief description of experience with High Sierra Botanicals product and/or High Octave Flower Essence Formula:

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I hereby give Holly Beatie permission to publish the above statement in full or paraphrased for informational and promotional purposes in connection with High Sierra Botanicals/High Octave Healing.

Permission granted to use (please check one)                   /   / full name               /   / initials only

Signature ___________________________                     Date _____________________________

Please return to:    High Sierra Botanicals, Attn: Holly Beatie, P.O. Box 4275, Truckee, CA 96160, Fax:   530-550-7537