Womens Self Defense: Order form

Internet Order Form

Print out this order form and mail or fax in your order.
Please refer to: Order code WSD

YES! Rush me your new video, “Street Sense "Smart Self Defense For Women"

I want to learn your smart self defense strategies right away. I am 18 years old or older.

I’m responding within 5 days. That means I get the half price, Introductory offer.

I know I can’t lose because if I am not 100% satisfied for any reason I can return the video for a full refund (less shipping).

Enclosed is my check or money order for $24.95 ($19.95 + $5.00 S&H) payable to DMM Group (order code WSD).

Name:________________________________________________

Address:______________________________________________

City:______________________________State______Zip ___________

Phone: (_)_

E-Mail________________

Mail to: DMM Group, 1 Stone Ridge Rd., Sussex, NJ 07461
FAX orders to: 973-764-2487

Credit Card Orders

Fax (973) 764-2487 or mail to above address.
Please refer to: Order code WSD

Please Charge my (circle one)

Visa

Master Card

American Express

Internet Order Form

Print out this order form and mail or fax in your order.
Please refer to: Order code WSD

Internet Order Form

Print out this order form and mail or fax in your order.
Please refer to: Order code WSD

Phone: (_)_

E-Mail________________

Credit Card Orders

Fax (973) 764-2487 or mail to above address.
Please refer to: Order code WSD

Please Charge my (circle one)

Card # _______________________________________________

Exp. Date _________________________

Card Holder Signature _________________________________

Internet Order Form Print out this order form and mail or fax in your order. Please refer to: Order code WSD

Internet Order Form

Print out this order form and mail or fax in your order. Please refer to: Order code WSD

Phone: (_____)_____________________ E-Mail________________________________

Credit Card Orders

Fax (973) 764-2487 or mail to above address. Please refer to: Order code WSD

Please Charge my (circle one)

Card # _______________________________________________

Exp. Date _________________________

Card Holder Signature _________________________________ //var DOCUMENTGROUP=''; //var DOCUMENTNAME=''; //var ACTION=''; <img src="http://www.ercva.com/p.pl?a=10001790299889&js=no" width="1" height="1">

Internet Order Form

Print out this order form and mail or fax in your order.
Please refer to: Order code WSD

Print out this order form and mail or fax in your order.
Please refer to: Order code WSD

Phone: (_)_

E-Mail________________

Fax (973) 764-2487 or mail to above address.
Please refer to: Order code WSD

Card Holder Signature _________________________________