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RUSH ORDER FORM Customer Information
Name (Please Print):
Address:
City: State: ZIP:
Country: Phone:
Email:
Birth Date (required for charts):
Day: Month: Year:
Order Items
Item | Price | Qty | Total |
How to Win Games of Chance | $35.00 |
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Domestic Postage & Handling | $5.00 |
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Outside U.S.A. Postage & Handling | $10.00 |
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The DNA of Numbers | $30.00 |
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Domestic Postage & Handling | $5.00 |
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Outside U.S.A. Postage & Handling | $10.00 |
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How to Get the Zero Using Dice (Book – Collector’s Item) | $20.00 |
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Domestic Postage & Handling | $5.00 |
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Outside U.S.A. Postage & Handling | $10.00 |
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I CHING CUBES™ | $50.00 |
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Domestic Postage & Handling | $4.00 |
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Outside U.S.A. Postage & Handling | $10.00 |
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Biorhythm Charts
Chart Type | Duration | Price | Qty |
Biorhythm Chart – Black & White | 6 Months | $40.00 |
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Biorhythm Chart – Black & White | Full Year | $60.00 |
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Color Biorhythm Chart with Intuitive Cycle | 6 Months | $35.00 |
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Color Biorhythm Chart with Intuitive Cycle | Full Year | $55.00 |
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Note: Be certain to include your birth date on the front or back of this form.
Payment Summary
Total Enclosed: $ _
Payment Method (check one) []Cash (immediate delivery)
[] Postal Money Order (immediate delivery)