| Mail or Fax in your order |
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(click here to return) | Print out the following order form and either: |
| - Fax it to:
Local: 02-9460-8098 International: 612-9460-8098 - Snail mail it to:
AffirmWare Pty Ltd Suite 30/116 Shirley Rd Wollstonecraft NSW 2065 Sydney, Australia
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Yes, rush me the 7-MP3 audio self-hypnosis package from HypnosisEzy, (a division of AffirmWare Pty Ltd). |
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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 |
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Credit Card (Check One) |
VISA Bank Card Master Card
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Credit Card #: | . _________________________. |
Expiry Date: | . _________________________. |
Name on card: | . _________________________. |
Signature: | . _________________________. |
Other:
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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. |
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| Mailing address: Suite 30/116 Shirley Rd Wollstonecraft NSW 2065 Sydney, Australia 612-9460-8098 Contact Detials |