Self Defense: Order form

Internet Order Form

Print out this order form and mail or fax in your order.

If you prefer you can call in your order at (973) 764-3311
Please refer to order Code Win-PIK.

YES! Rush me your new video “Winning On The Street - How to have an unfair advantage over any attacker.” I want to learn your powerful fighting strategies right away. I am 18 years old or older.

I know I can’t lose because if I am not 100% satisfied for any reason I can return the video for a full refund.

Double YES! I’m responding within 5 days. That means I also get the special bonus video “Weapons Of The Body” absolutely free.

Please send me (circle one):

DVD's

VHS Tapes

Enclosed is my check or money order for $47.70 ($39.95 + $7.75 S&H) for videos or $49.70 for DVDs, payable to DMM Group (Order CodeWin- PIK).

Name:________________________________________________

Address:______________________________________________

City:______________________________State______Zip ___________

Phone: (_)_

E-Mail________________

Mail to: DMM Group, 1 Stone Ridge Rd., Sussex, NJ

Credit Card Orders Fax to 973-764-2487 or mail to above address.

Please Charge my (circle one)

Visa Master Card

American Express Discover

Internet Order Form

Print out this order form and mail or fax in your order.

If you prefer you can call in your order at (973) 764-3311
Please refer to order Code Win-PIK.

Internet Order Form

Print out this order form and mail or fax in your order.

If you prefer you can call in your order at (973) 764-3311
Please refer to order Code Win-PIK.

Phone: (_)_

E-Mail________________

Credit Card Orders Fax to 973-764-2487 or mail to above address.

Please Charge my (circle one)

Card # _______________________________________________

Exp. Date _________________________

Card Holder Signature _________________________________

Internet Order Form Print out this order form and mail or fax in your order. If you prefer you can call in your order at (973) 764-3311 Please refer to order Code Win-PIK.

Internet Order Form

Print out this order form and mail or fax in your order.

If you prefer you can call in your order at (973) 764-3311 Please refer to order Code Win-PIK.

Phone: (_____)_____________________ E-Mail________________________________

Credit Card Orders Fax to 973-764-2487 or mail to above address.

Please Charge my (circle one)

Card # _______________________________________________

Exp. Date _________________________

Card Holder Signature _________________________________

Internet Order Form

Print out this order form and mail or fax in your order.

If you prefer you can call in your order at (973) 764-3311
Please refer to order Code Win-PIK.

If you prefer you can call in your order at (973) 764-3311
Please refer to order Code Win-PIK.

Phone: (_)_

E-Mail________________