This document appears to be an order form for fundraising products from Organo Gold, an independent distributor of coffee and tea infused with Ganoderma lucidum mushroom extract. The form collects customer names, addresses, phone numbers and fundraising information. It lists various coffee, tea and hot chocolate products available for purchase, including gourmet black coffee, latte, mocha, green tea and hot chocolate. The products are said to provide energy, vigor, stamina and support immune and brain function.

1. Name:
Address:
City: State: Zip:
ORGANO GOLD FUNDRAISER ORDER FORM
Gourmet Latte
Organic Green Tea
Gourmet Black
Gourmet Mocha
Chocolate
Gourmet Hot
First Name:
Last Name:
Phone:
Fundraising For:
Contact:
Customer’s Name/Address/Phone TOTAL QUANTITIES DUE
1. Ph:
Add:
2. Ph:
Add:
3. Ph:
Add:
4. Ph:
Add:
5. Ph:
Add:
6. Ph:
Add:
7. Ph:
Add:
8. Ph: FUNDRAISING
Add:
9. Ph: FORM
Add:
TOTAL QUANTITIES
DUE INDEPENDENT ORGANO GOLD DISTRIBUTOR
DISCLAIMER: "All independent fundraising initiatives are the responsibility of the Independent OrGano Gold Distributor and
the non-profit organization listed on this form. As a matter of policy, OrGano Gold International, Inc. and its partners do not
Name:
endorse any charitable or non-profit organization, foundation, trust or other entity . Any questions related to this organization
or transaction should be addressed directly with the organization or with the Independent Distributor at the phone number Phone: OG ID#:
provided on this form.
OGF_10-015_v.071910

2. PRODUCTS
“The Healthier Coffee”
INDEPENDENT ORGANO GOLD DISTRIBUTOR
Gourmet Black Coffee - Organo Gold’s Gourmet Black Coffee is sure to attract
100% ORGANIC GANODERMA LUCIDUM and awaken your senses. Its dark bitter taste and deep aroma infused with 100%
Revered for over 5,000 years as the world's number one 'superior' Organic Ganoderma introduces coffee lovers to a healthy alternative. With OG’s
herb. 100% ORGANIC GANODERMA LUCIDUM is also scientifically Black Coffee, Instantly enjoy the taste of fresh brewed coffee.
proven worldwide as nature's most potent health booster . It is
associated with longevity, youthfulness, vitality and virility. By
infusing gourmet coffee and an ever expanding product line with the
power of the Ganoderma Lucidum herb, Organo Gold has crafted a Gourmet Latte - A House Favorite, OG Gourmet Latte blends high
healthier alternative to regular coffee that not only tastes great, but quality aromatic Arabica coffee beans with 100% Organic Ganoderma extract. Per-
makes people feel great. fect for breakfast or a relaxing drink, the coffee’s light, sweet & creamy taste com-
bined with the energy boosting Ganoderma makes the ideal start for any morning.
Product Overview
Organo Gold is strategically partnered with a world class manufacturer of
100% Certified Organic Ganoderma Lucidum , also known as Lingzhi or
Reishi. The processing plant for our Ganoderma based products is built Gourmet Mocha - Our aromatic coffee combined with the finest cocoa brings
with GMP standards (highest in the world). about our guilt free “Liquid Dessert” in a cup. OG’s Gourmet Mocha combines a
The foundation of the Organo Gold product line is the “Miraculous King sweet rich coffee taste and 100% Organic Ganoderma Lucidum for the perfect ener-
of Herbs”, 100% Organic Ganoderma Lucidum. gizing after-dinner drink.
Featuring: 100% Organic Ganoderma Lucidum Capsules, Ganoderma
Spore Powder, Ganoderma Mycelium, Healthy Beverages, Nutraceuticals,
Skin Care, and more to come. Organic Green Tea - Exceptionally soothing and flavorful character of
Green Tea combined with the healthy benefits of 100% Organic Ganoderma
Benefits of the “Miraculous King of Herbs” provides a drink rich with antioxidants. Ganoderma Lucidum oxygenates the
body while supporting a healthy immune system.
Provides more energy and vigor!
Boosts stamina! (Less fatigue)
Rejuvenates! Gourmet Hot Chocolate - Unique blend of smooth rich chocolate
Oxygenates body! taste and 100% Organic Ganoderma extract warms your body while sup-
porting your immune system during cold days. Highly requested, OG is
Natural detoxification! proud to present a great tasting drink that everyone can enjoy.
Mental alertness!
Supports the immune system! DISCLAIMER:
These statements have not been reviewed or evaluated by the U.S. Food and Drug
Administration or Health Canada. Organo Gold products are not intended to diagnose,
treat, cure, or prevent any disease or class of diseases.