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Affiliate Program
De-Stress for Success!
Order Form
Note: Please complete the order form and submit it,
or you may print out the form and fax it to us at:
(713) 910-6191.
Easy Secure Online Order Form!
HDI Inc. Secure Order Form
Protected by The Safest Encryption Techniques
First name:
Last name:
Email address:
Company (optional)
Address 1:
Address 2:
City:
State:
Zip code:
Phone:
Product Format Desired?
Email (E-Book Format)
CD Rom
Diskette
Credit Card Number#
Expiration Date:
Type of Credit Card:
Checking Account# (Please allow 3-5 days to clear.)
Bank Routing#
Bank Name
Bank Phone Number#
De-Stress for Success!
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