FAT STATS Weight
Management Course
ENROLLMENT and ORDER FORM
(Please Print or Type)
Name:
_____________________________________________________
Address: ___________________________________________________
City: __________________________ State: ______ Zip: _____________
Country: ___________________________________________________
| # _________ | FAT STATS Weight Managment Course $
30.00 each (2 Personalized Body Profiles AND one copy of FAT STATS: A Guide to Weight Control) (Kansas residents add $ 1.85 tax = $ 31.85) ** (Outside the USA send e-mail for shipping amount) |
$ _________ |
|
||
| # _________ | FAT STATS Personalized Body Profile $
12.00 each (Kansas residents add $ 0.74 tax = $ 12.74 each) ** (Outside the USA send e-mail for postage amount) |
$ _________ |
| # _________ | FAT STATS: A Guide to Weight Control $
10.95 each (Kansas residents add $ 0.67 tax = $11.62 each) |
$ _________ |
| If the book is to be shipped in USA add $
3.50 per book ** (Outside the USA send e-mail for shipping amount) |
$ _________ | |
| If you ordered a book, check here if you want it autographed |
_________ | |
TOTAL |
$ _________ |
_____Check _____MasterCard
_____VISA _____AmExp
|__|__|__|__| |__|__|__|__|
|__|__|__|__| |__|__|__|__|
Credit Card Number
_____ /_____
Exp Date: Month Year
X______________________________________________
Signature if using credit card as method of payment
If paying by check or Money
Order make payable to FAT STATS
Send to:
FAT STATS
PO Box 4004
Dept D
Topeka KS 66604
785-233-9203
800-444-7215
or:
FAX to: 785-233-1531
or:
E-Mail this ENROLLMENT and ORDER FORM to:
102711.3602@compuserve.com
|Author| - |The 5 Keys| - |Course| - |Profile| - |Book| - |Order| - |E-Mail|
Fat Stats and the Fat Stats logo are registered to David H. Fisher Productions, Inc. and may not be used, redistributes and copies in any form without the written permission of David H. Fisher Productions, Inc. (R) 1997