Order Form

Stop Smoking Now  -    Tape _____    CD  _____           $20.00

Lose Weight Now    -     Tape _____    CD  _____           $20.00

Relaxation Now       -     Tape _____    CD  _____          $20.00

                                                                   subtotal

                                                                   shipping         5.99

                                                                     Total         _____

Ship to:

    Name _______________________

    Address _____________________

                 _____________________

                ______________________

Send Check or Money Order to:

    Paul Payne

    PO 53161

    Fayetteville, NC  28305

 ORDERS SHIPPED WITHIN TWO WEEKS