Pre-Recorded Tapes and CDs Order Form

 

Personal Information:

First Name:     Last Name: 

Street Address: 

City:     State:     Zip Code: 

Home Phone:  Area Code:    Number: 

Work Phone:  Area Code:    Number:     Extension: 

E-mail: 

Ship-to Address (required if different than above):

Name: 

Street Address: 

City:      State:    Zip Code:  

Pre-Recorded Tapes and CDs Order Info:

Description

CD
$ 26.75 ea.

Tape
$ 26.75
ea.

 Quantity Total
(in dollars)
Self Confidence 1995 S
Weight Loss Trigger 1995 A
Male Sexual Satisfaction 1997 S
Female Sexual Satisfaction 1997 S
Self Acceptance 1995 S
Anxiety Reduction 1995 M
Memory Improvement 1995 M
Smoke Free 1995 A
Raising Test Scores 2000 M
Listening Skills 2000 M
Pain Management 2001 H
Self Healing 2001 H
Order Total: (amount of check in Dollars):

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We respect your privacy.  Your name and address will never be given out or made available to other companies.