Order Form Numerology Calcualtor Select

Please Print this Form for FAX or Mail Orders.

C K Marketing Inc.
3629 NW 10th Street
Oklahoma City, OK 73107
Phone: 405.600.3043 || FAX: 405.601.0570

NAME:

E-MAIL:

Program Registration Name:

ADDRESS:

PHONE:

ID. No. ITEM DESCRIPTION PRICE

1. SW-400 Numerology Calculator Select Single User License $20.00

2.

3.

4.

TOTAL:

C K Marketing Inc. 3629 NW 10th Street Oklahoma City, OK 73107 Phone: 405.600.3043 \|\| FAX: 405.601.0570
NAME:
E-MAIL:
Program Registration Name:
ADDRESS:

PHONE:

METHOD OF PAYMENT
Check [ ]	Money Order [ ]	MasterCard [ ]	Visa [ ]	PayPal [ ]

CREDIT CARD INFORMATION *
NAME ON CARD:
CARD NUMBER:
EXPIRATION DATE: ____________	SECURITY CODE: ______	SIGNATURE:

* Your credit card statement will list "Jan's Jewelry Supplies" and not "2Near the Edge". *

Program Registration Name

To purchase a Single User License you must provide the name of the user to register the program to. Please note that this name will be printed in the footer of all reports and locked within the program.

	ID. No.	ITEM DESCRIPTION	PRICE
1.	SW-400	Numerology Calculator Select Single User License	$20.00
2.
3.
4.
		TOTAL: