You may print out the order form to Fax(credit/debit cards only)-24
hours a day-or
Mail-In your order form(credit/debit cards, cash, checks, money orders) to us by post. Our order fax number is: (310) 516-0310. All fax orders are kept
secure and 100% confidential.
Order Form (Print Out):
Adwealthclub Membership
$135(US) $155(Canadian Orders) $175(International
Orders)
Name:_____________________________________________
Address:___________________________________________________
City,
State/Province:____________________________________________
Zip:____________
Country:_____________________________________
Telephone(with
area code):______________________________________
Full email
address:______________________________________________
Fax(with area
code):_____________________________________________
Payment Amount:_____________________
Payment Type: ( )Cash ( )Check ( )Money Order ( )Visa ( )Mastercard ( )American Express ( )Discover
Credit/debit card number:_______________________________ Exp. date:_________ Billing Address:___________________________________________________________ Mail this form to: PHEA INTERNATIONAL MARKETING
P.O. BOX 11271, Carson, California 90749 |