Mail or Fax in your order

(click here to return)

Print out the following order form and either:

 

  1. Fax it to:

    Local: 02-9460-8098
    International: 612-9460-8098
     
  2. Snail mail it to:
    AffirmWare Pty Ltd
    Suite 30/116 Shirley Rd
    Wollstonecraft NSW 2065
    Sydney, Australia

 

Yes, rush me the 7-MP3 audio self-hypnosis package from HypnosisEzy, (a division of AffirmWare Pty Ltd).

 

 

 

Address Details:
 

 

First Name:

.
_________________________.

Last Name:

.
_________________________.

E-mail Address:

.
_________________________.

 

(double check spelling as this is where your download instructions for the "7-MP3 audio self-hypnosis package" will be sent)

Company:
(Optional)
 

.
_________________________

Address:

.
_________________________

City:

.
_________________________

State:

.
_________________________

Zip:

.
_________________________

Country:

.
_________________________

Phone:

.
(___) ____ - ______

( ) I am enclosing a check or money order for $97.00 (USD) for the 7-MP3 audio self-hypnosis package. Please note that we do not accept checks by fax, so if you are paying by check you must mail it in.

( ) I want to charge this purchase to my Credit Card

 

 

Credit Card (Check One)

VISA
Bank Card
Master Card

 

Credit Card #:

.
_________________________.

Expiry Date:

.
_________________________.

Name on card:

.
_________________________.

Signature:

.
_________________________.


Other:

 

Where did you
here about HypnosisEzy

 

_________________________

 

Your credit card will be billed for a total of $97.00 (USD). Installation instructions will be emailed to you once your payment is processed, usually within 24 Hours.

 

I authorize AffirmWare Pty Ltd to charge $97.00 (USD) to my credit card for the purchase of the 7-MP3 audio self-hypnosis package.

 

 

Mailing address:
Suite 30/116 Shirley Rd
Wollstonecraft NSW 2065
Sydney, Australia
612-9460-8098
Contact Detials