Regular Mail Order Form
You should use this order form if you are going to use a check or money order to purchase the Ultimate Weight Loss eBook.  You may either print out this order form or write all the information down on a piece of paper.
Please provide the following information:

Name: _________________________
 
 

Address: _______________________

                   _______________________
 

Email: _________________________  (this must be legible or we can not email the program)
 

Please indicate your purchase:
Please mark the open box with an "X" or write your selection on a piece of paper.
 
  The Ultimate Weight Loss eBook via email

The eBook will be sent the day that payment is received through the mail.
Please be sure to include your email address.

 $17.95
The Ultimate Weight Loss eBook printed version (CURRENTLY NOT READY)

Please note that because this is a printed version, it is non interactive.  A $3 shipping and handling has been included.  Order will be shipped via first class mail once payment is received.

 $23.95

Make check or money order out to:
Email: rob@freeweightloss.com for mailing address.