Self Defense: Order form

Internet Order Form

Print out this order form and mail or fax in your order.
Please refer to: Order code: FREE DVD

YES! Rush me your new DVD, “Street Self Defense 101 - Mini Course- "Self Defense That Really Works ". I want to learn your powerful fighting strategies right away. I am 18 years old or older and I understand these techniques are so effective, so powerful and so devestating that I will only use them to protect myself and my loved ones.

Enclosed is my check or money order for $4.95 for postage and handling, payable to:
DMM Group (order code FREE DVD).

Name:________________________________________________

Address:______________________________________________

City:______________________________State______Zip ___________

Phone: (_)_

E-Mail________________

Mail to: DMM Group, 1 Stone Ridge Rd., Sussex, NJ 07461
FAX orders to: 973-764-2487

Credit Card Orders mail to above address, or FAX to 973-764-2487
Please refer to: Order code: FREE DVD

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.
Please refer to: Order code: FREE DVD

Internet Order Form

Print out this order form and mail or fax in your order.
Please refer to: Order code: FREE DVD

Phone: (_)_

E-Mail________________

Credit Card Orders mail to above address, or FAX to 973-764-2487
Please refer to: Order code: FREE DVD

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. Please refer to: Order code: FREE DVD

Internet Order Form

Print out this order form and mail or fax in your order. Please refer to: Order code: FREE DVD

Phone: (_____)_____________________ E-Mail________________________________

Credit Card Orders mail to above address, or FAX to 973-764-2487 Please refer to: Order code: FREE DVD

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.
Please refer to: Order code: FREE DVD

Print out this order form and mail or fax in your order.
Please refer to: Order code: FREE DVD

Phone: (_)_

E-Mail________________

Credit Card Orders mail to above address, or FAX to 973-764-2487
Please refer to: Order code: FREE DVD