Goal Program

"Achieve Your Dreams" Order Form
Dream-Chasers.net

       (Please print out this order form)

Check, Cashier Check, Money orders and Credit Cards accepted. 


Name:______________________________________________________________
Address:____________________________________________________________
City:_______________________ State:___________ Zip:____________________
Phone:____________________________ Email:____________________________
Order Date:______________________ 

(  ) Mail Package to the address above.   (  ) Mail Package to the address below.

Name:______________________________________________________________
Address:____________________________________________________________
City:_______________________ State:___________ Zip:____________________
Phone:____________________________ Email:____________________________

The "Achieve Your Dreams" package includes:

  • "Achieve Your Dreams" Goal Workbook
  • "Achieve Your Dreams" Relaxation CD
  • "Achieve Your Dreams" Goal Card

Item# AYD101

 Achieve Your Dreams
Goal Setting Program
$49.95 + $7.55
Shipping & Handling (US)

 

__________



(MN residents only)    6.5% Sales Tax


__________



TOTAL


__________

Please make check or Money Order payable to: Dream Chasers, Ltd

 

Credit Card information

Credit Card Number:____________________

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
(If different from above, please fill out the form below)

Name (As printed on your card):________________________________________
Address:____________________________________________________________
City:_______________________ State:___________ Zip:____________________
Phone:____________________________ Email:____________________________


Thank you for your order.

Mail to:
Dream Chasers, Ltd
P.O. Box 1044
Tracy, MN 56175

Phone (507) 212-1234

Delivery with in 1 to 3 weeks.