Please print and fill out completely. Any incomplete forms with missing information will be returned to sender. This form good for purchase of year membership only and needs to be mailed with a check or money order for $75 in US dollars only made out to: JEMERC, INC
|Shipping Address Street|
Mail completed form, check/money order to:
c/o JEMERC, INC
PO Box 383
Huntington, NY 11743 USA
This order form was created on October 10nd, 2016. To ensure this payment option is still valid, please visit http://johnedward.net/the-five/mail-order. If you do not see this form still up at this link, please email firstname.lastname@example.org to confirm this ordering option is still valid! If you have any questions, do not hesitate to contact us. This form is ONLY valid if you found it on JohnEdward.net.