ShrinkinaBox.com Mail Order Form

(print this form)

Date: _________________________  
First Name: ____________________ Last Name: _______________________
or Company Name:_____________________________________________________
Shipping Address: _____________________________________________________
City: ___________________________ State/Prov.: ______________________
Country: ________________________ Zip/Postal Code: _________________
Email: ________________________________________
Daytime Phone: (____)_____________ Evening Phone: (____)______________

 

Payment Details

 

Quantity

Ordered

Choose The Item(s) You Wish To Order

Price

(USD)

  'Secrets of Dealing with Difficult People' ebook ($23) $
  'Secrets of Dealing with Difficult People' soft cover book ($27) $
 

'Shrink in a Box' Personal Success System 3CDs/DVD ($49)

$
  'Everyday Power' 2CDs ($24.95) $
     
 

Add Shipping:

 
 

Soft cover book or book+CDs within Canada or the U.S. add
$8.49, Overseas add $15.99

$
 

CD programs within Canada or the U.S. add $6.49,

Overseas add $13.99

$
  All advertised bonuses will be included with your order. Free
 
Calculate Your Total:
$

 

MAIL THIS FORM TO:
Wellspring Personal Effectiveness
213 - 5325 Cordova Bay Rd

Victoria BC, Canada  V8Y 2L3
   

Please enclose your Cheque or Money Order payable to:

Dr Mark Lauderdale

Thank you.

For Assistance Please contact us.