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Fax Order Form Advanced Productivity Solutions FAX# 408-937-4049
Name______________________________________________ Date___________________
Company__________________________________________________
Shipping Address____________________________________________
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Billing Address______________________________________________
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Credit Card / Acct #_________________________________________
Expiration Date_________________________
Cardholder Name___________________________________________
Cardholder Signature_________________________________________
Phone Number______________________________________
Fax Number________________________________________
Email Address______________________________________________
SuperReading Self-Study Course(s)______ x $49.00 = total $_______
Wow-To! Self-Study Course(s).. .. ______ x $49.00 = total $_______
How To Win at ANY Sport....... .. ______ x $50.00 = total $_______
Remember Names & Faces......... .. ______ x $49.00 = total $_______
The Art of Visualization............ .. ______ x $49.00 = total $_______
Quick & Easy Memory............. .. ______ x $49.00 = total $_______
Grand total = $_______
RECESSION SPECIAL $99.00 (circle, fill in $99 in Grand Total)
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