Printer Friendly Order Form…

Name: (If paying byVisa or Mastercard, please give name as it appears on Credit Card.)

________________________________________________________________

Address: ______________________________________________________________

City: _____________________________ State:_______________ Zip:__________

Phone: ___________________________ E-Mail:_____________________________

Visa/Mastercard #___________________________________Exp. Date:__________

Signature:_____________________________________________________________

Send Check, Money Order, or Debit/Visa/Mastercard Information to:

Margaret and David Hiller

157 Egret Run Lane, #522

Pawleys, SC 29585

(843) 333-8260

miracles1@mindspring.com

Quantity: _________ @ $15 per Dare to Dream Book $_________

Quantity: _________ @ $10 per Healing Meditation Tape $_________

Quantity: _________ @ $10 per Shifting Into Miracle Thinking Tape $_________

Quantity: _________ @ $10 per Power of Healing in Forgiveness Tape $_________

Quantity: _________ @ $10 per Finding the Divine and Leap of Faith Tape $_________

Quantity: _________ @ $10 per Dare to Dream Tape $ _________

Quantity: _________ @ $20 per Large Shift Happens T-Shirt $_________

Quantity: _________ @ $20 per Extra Large Shift Happens T-Shirt $_________

Quantity: _________ @ $23 per Large Dare to Dream T-Shirt $_________

Quantity: _________ @ $23 per Extra Large Dare to Dream T-Shirt $_________

Sub Total $_________

Shipping and Handling: S & H $_________

For Orders up to $20, please add $4.00

For Orders $21 - $40, please add $6.00

For Orders $41 - $60, please add $8.00

For Orders $61-$100, please add $10.00

For Orders $101 - $200, please add $11.00 TOTAL $_______

Please allow 7 – 10 days for delivery.