End the Habit ORDER BY MAIL

ORDER BY MAIL

To order the End the Habit Stop Smoking Program by mail, simply print out this page, fill it in, and mail it to the address at the bottom. Or, if you prefer, just write the information on a piece of paper and send that. You can pay either by credit card - or by check or money order made out to Allegretto Publishing Ltd, in either US Dollars or Canadian Dollars (for mail orders, consider the exchange rate to be 1 to 1).

Please make sure you fill in ALL the information required! Please use BLOCK CAPITALS.

Your Name (As it appears on your credit card):
Your Email Address (use block capitals)
Your Telephone number:

Quantity	Description	Price USD$	Total
	End the Habit Deluxe Stop Smoking Program	197.00
	End the Habit Standard Stop Smoking Program	177.00
	Shipping & Handling: Canada & US -	24.95
	Shipping : Outside Canada & US -	39.95
	Sub Total
	Canadian residents, please add 5% GST
	TOTAL

□ I wish to pay by Credit Card:

Your Credit-Card Billing Address:

Zip/Postal Code:
Country:

Shipping Address (if different):

Zip/Postal Code:
Country:

Credit Card type: (please circle)

Visa Mastercard

Credit Card Number:

Expiry Date: MM/YY

Security Code from back of card: (look for the last 3 digits)

I authorize Allegretto Publishing Ltd, to charge to my credit card the total amount shown above.

________	__________________
date	signature

□ I have enclosed a check/money order payable in US or Canadian Dollars to Allegretto Publishing Ltd

Your order will be processed and shipped once your payment has been cleared. Please note that this can take several days.

Mail to:

Allegretto Publishing Ltd,
50 Southshore Drive,
Brooks, AB T1R 1M4,
Canada.

info@endthehabit.com