DynoWomyn Self-Help Order Form

DYNOWOMYN SELF-HELP ORDER FORM

To order from The DynoWomyn Self-Help Shop:

Email
Check below and then copy or cut and paste your selections and send, with appropriate Mastercard information, to drknight@odyssee.net.

Mastercard Orders via Fax
Print out this page, fill in ordering information (including Mastercard number and expiration date) and fax to: 1-514-485-3828

Postal Orders Print out this page, indicate your order, and mail (postal orders) along with Money Order or Mastercard information to Dr. Knight at the address below.

Note:  All Prices Are In U.S. Dollars

QUAN.	TITLE	PRICE	TOTAL
______	Self-Confidence	$39.95	______
______	Positivity	$39.95	______
______	Stop Smoking	$39.95	______
______	Serenity	$39.95	______
______	Relax and Let Go	$39.95	______
______	Freedom from Tranquillisers	$39.95	______
______	Mind & Hypnosis	$39.95	______
______	Weight C;ontrol	$39.95	______
______	Weight Loss	$39.95	______
______	Stress Control Save $10.00 This Month!	$29.95	______
Shipping and Handling:	$4.50 for the first item, plus $1.50 for each additional item.	+Postage	______
JK11698 - Tracking Code:		TOTAL:	______

        
       
                                            
	              
Name:_________________________________________

Address:______________________________________

Town/City: ___________________________________

State/Province:____________________

Country:_______________________

Postal or Zip code:____________

Telephone:_____________________

E-mail:________________________

Method of payment: 
         
(   )  Money Order
(   )  Mastercard #:___________________ Expiry Date: ____________ 
		              (Send in separate email if you like)

Name on card:_______________________________________

If mailing your order, send to:
Dr. Bryan Knight, 7306 Sherbrooke West, Montreal, Quebec, Canada H4B 1R7.

Email: drknight@odyssee.net. Fax : 1-514-485-3828

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