Free-Energy Order Form
www.free-energy.ws
Clear Tech,
Inc
Please
provide us with the following information.
Select
the product(s) you are ordering:
| Item |
Quantity |
Price
per Item |
Total
Price |
| The
Free Energy Secrets of Cold Electricity |
|
|
|
| DVD |
|
$29.95 |
|
| Video
- NTSC format |
|
$14.95
(Blow-out Price) |
|
| Book |
|
Not
Available at This Time |
|
| Electric
Motor Secrets |
|
|
|
| DVD |
|
$29.95 |
|
| Tesla's
Radiant Energy |
|
|
|
| DVD
|
|
$29.95 |
|
| The
World of Free Energy |
|
|
|
|
DVD |
|
$29.95 |
|
| The
History of E V Gray Motor |
|
|
|
| DVD |
|
$29.95 |
|
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added to your order when your credit card is processed. Click here to see
Shipping Info.
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to Address:
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Day
Phone __________________________Evening Phone :_____________________
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Number_______________________Email:________________________________
Credit Card Billing Information:
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________________________________________________________________
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Line: ______________________________________________________________
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or Province: ___________________________ Zip Code: ___________________
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Exp
date: _______ / ________ Circle Card Type: Visa - MC
- Discover
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of your card on the signature line)
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as it appears on card:
(Please Print):__________________________________________
Cardholder Signature:
___________________________________________
Fax
this completed form to +1-425-795-4786
or Email to - support @ free-energy.ws
Thank
you!
|
