"Achieve Your Dreams" Order Form
Dream-Chasers.net
(Please print out this order form)
Check, Cashier Check, Money orders and Credit Cards accepted.
Name:______________________________________________________________
The "Achieve Your Dreams" package includes:
Item# 1003R
Achieve Your Dreams
Which credit card are you using? ____ Visa ____Master Card ____ Discover
What is the expiration date on your card? _________ Month ______ Year
_____ Credit Card information is the same as above
Name (As printed on your card):________________________________________
Name:______________________________________________________________
Address:____________________________________________________________
City:_______________________ State:___________ Zip:____________________
Phone:____________________________ Email:____________________________
Order Date:______________________
( ) Mail Package to the address above.
( ) Mail Package to the address below.
Address:____________________________________________________________
City:_______________________ State:___________ Zip:____________________
Phone:____________________________ Email:____________________________
Goal Setting Program
$49.95 + $7.55 Shipping &
Handling
(US)
__________
Item#
FREE CD
Positive Affirmation CD
FREE + $5.95 Shipping & Handling
__________
(MN residents only)
6.5% Sales Tax
__________
TOTAL
__________
Please make check or Money Order payable to:
Dream Chasers, Ltd
Credit Card
information
(If different from above, please fill out the form below)
Address:____________________________________________________________
City:_______________________ State:___________ Zip:____________________
Phone:____________________________ Email:____________________________
Mail to: Delivery with in 1
to 3 weeks.
Dream Chasers, Ltd
212 3rd Street
Suite #4
Tracy, MN 56175