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Simply Helping Others - Order Form
 

"Simply Helping Others For Life" Enrollment Form

 
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Yes, Joseph! Please rush me your "Simply Helping Others For Life" program by First Class Mail. I am enclosing my $397 total payment ($197 to Box #1 below and $200 to Box #2 below).
 
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Yes, again Joseph! I am also ordering within the next 14 days or among the next 500 orders, so I am now eligible for the "Five For Life" pack (500 Free postcards, 500 Free names, 500 Free stamps)
 
Please Print or Type Clearly to Avoid Delay!
   
   
Name:___________________________________________________________

Address:_________________________________________________________

City and State:____________________________________________________

Zip Code:________________________________________________________

Daytime Phone (Office Use Only):_____________________________________

Payment By (Please Check One): _____Cash _____Money Order
 

BOX #1: MAIL THIS ENTIRE FORM AND $197 TO...

SUCCESS LIFE PUBLISHING
64 CASALINA DR. PMB 7711
NORTH AUGUSTA, SC 29861

(Make a check or money order made payable to)
Success Life Publishing


(Make sure to include a copy of Distributor's payment verification.
We'll check with Dealers to ensure proper payment was received.)
 
BOX #2: MAIL OTHER $200 DIRECTLY TO
THE DISTRIBUTOR AT...


GARY S. EVANS
PO Box 2340
Brentwood, NY 11717

(Make Postal Money Order payable to: Gary S. Evans)

Please feel free to contact me personally if you have any questions:
Phone: 631-664-2996