ORDER FORM

Please print, fill in and send to:

Mimi Lupin
P.O.Box 20345
Hot Springs, Ar. 71901



Date
 
BILL TO: SHIP TO:

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TERMS

SHIP DATE

PURCHASE ORDER # (school districts only*)
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Due on receipt _ TAX ID # __________________________________________
DESCRIPTION RATE QTY AMOUNT

Old Me New Me CD Program   3 CDs and Instructions
Create-An-Image-Relaxation Therapy ____________
Swimming With the Dolphins CD__________________ ___________________________________________
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$84
$49
$20
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$
$
$
$
$
Shipping and Handling ($5.00 within the U.S. for one or both)**          $5.00            ______ $
Sales Tax -Arkansas Only (8.5%) ______ ______ $
  TOTAL ______ $

* P.O. is sufficient from school districts only.
** For international shipping rates, contact Mimi Lupin at Mimi@mimilupin.com

Please make checks payable to Mimi Lupin.

In case we need to contact you please provide:
Phone Number __________________________   
Email Address ___________________________

If you would like to use a credit card but are concerned about internet security, please email your name and telephone number to info@oldmenewme.com and we will call you for your information.

To pay by Credit Card through PayPal:

(Old Me New Me CD)

(Swimming with the Dolphins CD)

( Create-An-Image Relaxation Therapy (CAIR))

To Download in MP3, Click Here

Guarantee: If you are not completely satisfied with this purchase, return it for a full refund within thirty (30) days of the shipping date.

Returns: Contact Schoolhouse for permission to return. Must be in new condition for resale and returned in original packaging with shipping prepaid. Include a copy of this invoice to ensure proper credit. Refunds will not be considered after thirty (30) days from shipping.

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