To order, send order form to:
Empower Publications
3166 N. Lincoln Ave., Suite 206
Chicago, IL 60657
PLEASE USE YOUR BROWSER TO PRINT THIS APPLICATION
(Close this window to return to the Dr. Jaystone web site)
Please Print:
Name ______________________________________________________
Address ____________________________________________________
City, State, Zip ______________________________________________
Home Phone (____)______________ Home Fax (____)________________
Email Address (Complete) ______________________________________
SELF-HELP PROGRAMS ON NEW CDs
Enclose $14.95 for each Compact Disk, plus tax if applicable;
shipping and handling is prepaid. Please allow 4 - 6 weeks for processing.
***********************************
Check boxes of CDs you wish to order:
< > CD001 Sacred Cycles
< > CD002 Lose Weight Through Hypnosis
< > CD003 Stop Smoking
< > CD004 Love and Light
< > CD005 Light As a Feather
< > CD006 Something Inside
< > CD007 Mental Preview / Mental Review
< > CD008 Look, Listen and Feel
< > CD009 The Four Rs
< > CD010 Past Life Regression
Total CD ordered: _______
************************************
Sacred Cylces Book(s)
$16.95 each plus $4.00 shipping and handling
for the first book and $1.50 for each additional book.
Total Book ordered: _______
S/H _______
Total book ordered: _______
Please allow 4-6 weeks for processing.
*************************************
TOTAL AMOUNT ENCLOSED: ________________
*************************************
Make check payable to: Empower Publications
Empower Publications
3166 N. Lincoln Ave., Suite 206
Chicago, IL 60657