WealthBible Mail Order Form

Print out the following order form and:

• Snail mail it to:
  AffirmWare:
  30/116 Shirley Road
  Wollstonecraft NSW 2065
  Sydney
  Australia

Yes, rush me the WealthBible program
 

Address Details:

First Name:

.
_________________________.

Last Name:

.
_________________________.

E-mail Address:

.
_________________________.

(double check spelling as this is where your download
instructions for the WealthBible will be sent)
 

Company:
(Optional)

.
_________________________

Address:

.
_________________________

City:

.
_________________________

State:

.
_________________________

Zip:

.
_________________________

Country:

.
_________________________

Phone:

.
(___) ____ - ______

(  ) I am enclosing a check or money order for $127.00 (USD)

(  ) I want to charge this purchase to my Credit Card

Credit Card (Check One)
 

VISA
Bank Card
Master Card

Credit Card #:

.
_________________________.

Expiry Date:

.
_________________________.

Name on card:

.
_________________________.

Signature:

.
_________________________.

Other:

Where did you here about WealthBible

_________________________

Your credit card will be billed for a total of $127.00 (USD). Installation instructions will be emailed to you once your payment is processed, usually within 24 Hours.
 

I authorize AffirmWare to charge $127.00 (USD) to my credit card for the purchase of Sculptor Affirmation Software.