My Name is : ______________________________________________
(Please print)
My Address is : ___________________________________________

City State ZIP : _________________ _______ _____________

Signed : ______________________________________________

In Addition I would like these items (checked):

Biography
shipping/handling
s/h Overseas surface mail
s/h Overseas air mail
Total
$29.95
$3.25
$8.00
$15.00
$______


Annual Cycle of Periodicity
s/h (US)
s/h + Overseas Air
Total
$15.00
$2.55
$3.55
$______


Secret of Personal Power
shipping/handling
s/h Overseas air mail
Total
$15.00
$2.75
$4.30
$______


Annual Cycle & Secret of Personal Power
shipping/handling
s/h Overseas air mail
Total
$20.00
$3.20
$5.50
$______


TOTAL AMOUNT ENCLOSED $________._____