
| Mail or Fax in your order |
(click here to return) | Print out the following order form and either: |
- Fax it to (02) 9231-4101
- Snail mail it to:
AffirmWare: 30/116 Shirley Road Wollstonecraft NSW 2065 Sydney Australia
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Yes, rush me the Sculptor Method. |
Address Details: | |
First Name: | . _________________________. |
Last Name: | . _________________________. |
E-mail Address: | . _________________________. |
| (double check spelling as this is where your download instructions for the "Sculptor Affirmation Software" will be sent) |
Company: (Optional) | . _________________________ |
Address: | . _________________________ |
City: | . _________________________ |
State: | . _________________________ |
Zip: | . _________________________ |
Country: | . _________________________ |
Phone: | . (___) ____ - ______ |
( ) I am enclosing a check or money order for Sculptor $97 (USD) Please note that we do not accept checks by fax, so if you are paying by check you must mail it in. ( ) I want to charge this purchase to my Credit Card |
| |
Credit Card (Check One) |
VISA
Bank Card
Master Card
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Credit Card #: | . _________________________. |
Expiry Date: | . _________________________. |
Name on card: | . _________________________. |
Signature: | . _________________________. |
Other:
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Where did you here about Sculptor | _________________________ |
| Your credit card will be billed for a total of $97 (USD). Installation instructions will be emailed to you once your payment is processed, usually within 24 Hours. |
| I authorize AffirmWare to charge $97 (USD) to my credit card for the purchase of Sculptor Affirmation Software. |
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| | Mailing address: Jeff Staniforth (AffirmWare) 30/116 Shirley Road Wollstonecraft NSW 2065 Sydney Australia 61-2-9460 8098 affirm@affirmware.com.au |