Order by Credit Card

Please make sure that the information below is correct.


                    I am purchasing the Product for:

                     $29.95

              Name: 

           Address: 

              City: 

             State: 

               Zip: 

      Phone Number: 

     Email Address: 

Credit Card Number: 

        Expiration:  (MM/YY)

      Type of card: Visa  Mastercard 

              Note: Only Visa and MasterCard accepted.



Thank you for your order. I will send the "Customer Code" to your email address or postal mailing address (if no email box) to complete your registration.