Referral Flood Priority Order Form

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[ ]Yes, rush me the Referral Flood 3 ring binder and Audio CD set including my two bonus programs (audio CD Instant Referral Systems and free consultation coupon)

I understand that I have a full 90-days to review the material and decide whether or not they meet my needs.

Payment option:          
[ ] check payable to Jantsch Communications, Inc.
[ ] MasterCard     [ ] Visa    [ ] American Express    [ ] Discover

                                           

Name:______________________________________

Business: ____________________________________

Address: ___________________________ City ______________

St: ______ Zip/Postal _________________ Country ___________

Phone: ___________________ email ______________________

Signature : ___________________________________________

Name on Card: ________________________________________

Card Number:________________________ Exp Date: _________

Charge on Credit Card will appear as Jantsch Communications, Inc.

3 Ring Binder Options

[  ] Referral Flood 3 ring binder and audio CD program United States $129 + 10.95 = $139.95
[  ] Referral Flood 3 ring binder and audio CD program Canada/Mexico $129 + 14.95 = $143.95
[  ] Referral Flood 3 ring binder and audio CD program International $129 + 18.95 = $157.95

Mail to: Jantsch Communications - 4806 Belleview Ave, Kansas City, MO 64112
or FAX to: 816-363-5412

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