ORDER PAGE

To order any of the HBEA Super Opportunity Store products or opportunities, click on the drop down box(s) to choose. Add up what you selected and place the total in the total box.

First Order:                 

Second Order:            

Third Order:                

Fourth Order:              

Fifth Order:                 

Total Paid:                 
(All products include Shipping & Handling charges.  Do not include monthly fees in 'Total Paid')



Please fill in the following completely.
(If you are ordering the HBEA Personal Web Site or Liquid Email Master Broker Virtual Label Web Site, also mark the check boxes adjacent to each item that you wish to have included on your Web Site home page.)



Yes!     Name:                   

Yes!     Company:              

Yes!     Address:                

Yes!     City:                      

Yes!     State:                     

Yes!     Zip:                         

Yes!     Phone(Day):           

Yes!     Phone Night:          

Yes!     Email:                     


Please Charge My:
Visa
Mastercard
 

Card Number:   

Expiration
Date:          

Name on Card:  

I authorize you to charge my credit card for the choices I have selected above, and also authorize you to charge
my credit card for the monthly payments associated with any of my above choices.  I reserve the right to write
at any time and cancel this option, with 30 days notice.

    

Or you can MAIL TO: HBEA, 50 W. 3rd Street, Ste. 204, Holland, MI 49423
For faster service fax credit card or check orders to: 616-355-7276
 
 

Copyright © 1998, 1999 HBEA