Powermat Order Form
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Powermat/s to me.
I am sending US$
by Demand Draft or International Money
Order to the Payee
at the address
shown at the bottom
of this page.
I am paying by credit card (please see below)
( Note: If you are
a resident of India, you need not send any money now.Your order
will be executed
by Value Payable by Post (V.P.P.) )
My mailing address is: Name Street Area City State Zipcode Country As soon as you recieve my order please inform me by e-mail. My e-mail address is: (Privacy Statement: Information supplied by you will not be transferred to any third party)
Payment by Credit Card
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The payment indicated above is basic price+credit card transaction cost+shipping cost(Business Express)
I know that if I do not feel any change in me within a week I will get a full refund minus shipping charges if I return the Powermat to the return address below.
PAYMENT & RETURN ADDRESS:
(All payments (except credit card payments) are to be made to the payee
named below by Demand Draft
or International Money Order)
Mrs B.J.Minz,
'Cosy Corner',
27 Nayatoli Lane,
Old Hazaribagh Road,
Ranchi-834 001
Bihar, INDIA
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