Print Name: ___________________________________________________________
Street Address: ___________________________________________________________
City: _____________________________ State: __________ Zip: ______________
Phone contact if questions with order: Day: _________________ Evening: ________________
Signature: ___________________________________________ Date: ______________
|
Payment Method:
|
CHECKS ONLY PLEASE – No Credit Cards accepted at this time |
|
Checks Payable to:
|
Shawn O’Regan |
|
Mail Order to:
|
P.O. Box 2 Allenton, MI 48002-0002 |
|
Call to order:
|
(810) 798-3884 and pick up or have your order shipped to you. |
|
Pick Up Order at:
|
Save shipping fees, call in advance to arrange to pick up your order at: Mercy Health Center, 4190 - 24th Avenue, Fort Gratiot, MI 48059 |
CD’s = $14.97 each or 3 for $40 |
||||||
| TITLE |
CD $
|
Tape $
|
Quantity
|
Total
|
||
| “10 Minute C.E.O. Power Nap” | ________ | ________ | X | ________ | = | _________ |
| Manage your Mind, Manage your Weight | ________ | ________ | X | ________ | = | _________ |
| STOP Smoking Relaxation | ________ | ________ | X | ________ | = | _________ |
| Pre-Talk about Hypnosis | ________ | ________ | X | ________ | = | _________ |
| Stairway to Relaxation | ________ | ________ | X | ________ | = | _________ |
| Therapeutic Waterfall | ________ | ________ | X | ________ | = | _________ |
| BOOKS | ||||||
| The Knight in Rusty Armor |
$ 9.95
|
X | ________ | = | _________ | |
| Little Book of Change – A primer to Hypnosis |
$ 7.95
|
X | ________ | = | _________ | |
SUB-TOTAL: |
_________ | |||||
| Add $2.00 Shipping and Handling for 1st item |
$2.00
|
|||||
| Additional items $1.00 each |
$1.00
|
X | ________ | = | _________ | |
TOTAL DUE: |
$________ | |||||