AGS Fuel Vaporizer GLS
                                                                                               DISTRIBUTORSHIP PURCHASE FORM
                   Your fuel economizer distributorship one stop order form. Just follow the instructions for you who are Fuel Vaporizer GLS distributors.    Be on your way to success today, its that simple.
AGS Fuel Vaporizer GLS
P O  Box  1699
Riverton, Wyoming 82501
 Order (888) 436-0899
    e'FAX: (208) 692-3632
    As a distributor of the AGS Fuel Vaporizer GLS. I understand that I am fully authorized to purchase certificates on a quantity basis. Without filling out a regular Fuel Vaporizer GLS for each and every certificate that I obtain. So long as I recognize that the rules and guidelines set forth in the regular Application applies fully. And in every detail to each and every kit that I obtain even though they are in quantity form. And basically that is, that the membership is a purchase, and a Fuel Vaporizer GLS (product) is part of the sale which accompanies each and every kit.

    I further understand that the cost of each (        minimum) Fuel Vaporizer GLS as a distributor (unless otherwise notified) shall be {call for details} inside the U.S. Borders, for all materials involved. Which must be paid at the time of the purchase, unless otherwise agreed to in writing. And includes a Fuel Vaporizer GLS kit as is.
    Having fully understood the foregoing statements, I the undersigned do hereby agree that when I set forth my signature on this Order Form, that I fully agree with these terms, and shall abide by them on each and every Fuel Vaporizer GLS purchased:
I, The Undersigned Do Hereby Express My Desire
To Purchase _______ Fuel Vaporizer GLS kits as quoted
I am mailing in an order in the amount of $_____________


(Discount on PO Money Order’s - only purchase price on each Unit less S&H)
US Postal Money Order # ______________        Amount $_______.___
Make Payable and Mail to: AGS FV   GLS
                                                PO Box 1699
                                                Riverton, Wyoming 82501
Distributor's (Associate)#:_______   {issued on order received}
        Distributor's Name (type or print clearly): ____________________________
Valid & Current Email: ____________________________                                    Today:                                       

Ship to:____________________________________      Tele: (       )          
City:___________________________   State/Province:________________________________   Zip:_______



Attn:   Distributor,
    When you order, please fill out this Purchase Form and mail it to us at the address above along with your payment made. (If purchase is paid by bank check or bank money order, do not expect order shipped until check has cleared your bank).
IMPORTANT NOTE:
    Each purchase after this must be accompanied by total number purchased on a note with your order, otherwise a 2nd purchase CAN NOT be honored till you contact us. The warranty is void for each and every unit in quantity if repair work is requested but found tampered with.
IF THE (Fuel Vaporizer GLS) product HAS BEEN TAMPERED WITH - SUCH AS DISMANTLED IN FULL OR IN PART, OR CHANGED IN ANY WAY, THE WARRANTY IS IMMEDIATELY VOID.
Quick order:
For a single purchase form email Customer Service. To place a small order {non dealer price}secure online click here, order will processed online, thank you.