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Order Form
 
CONTACT INFORMATION

     Please provide the following contact information:

First Name   Last Name  
Street Address   Address (cont.)  
City   State  
Zip Code   Profession  
Home Phone   Work Phone  
Cell Phone   FAX  
Email      
 
ITEM SELECTION
     Please select the products you would like to order:    

 

Product Quantity / Price
Seminar DVD: Myofascial Release Level 1  
Manual: Myofascial Release Level 1  
Seminar DVD: Myofascial Release Level 2 w/ Craniosacral Therapy  
Manual: Myofascial Release Level 2 w/ Craniosacral Therapy  
Seminar DVD: Integrated Neuromuscular Re-Education, Muscle Energy & Positional Release 1  
Manual: Integrated Neuromuscular Re-Education, Muscle Energy & Positional Release 1  
Multi-Dimensional Healing  

All prices include shipping and handling.

NY State Residents ONLY: must add 8.625% sales tax to your order.

Prices and availability subject to change without notice and while supplies last. Products are shipped by common carrier unless other arrangements are made on advance, at cost. Damage or service claims must be reported directly to the carrier. All sales are final. Educise assumes no responsibility for the use or misuse of any product or service by individuals or businesses. No medical/health claims are implied or warranted by the use of any product. It is advised that you seek medical care from your physician if you have a health or medical problem. Products are not FDA tested or approved.

PAYMENT METHOD

     Please enter the following payment information for the above ordered products:

Pay Method:  
Cardholder Name:  
Credit Card #:  
Credit Card Code:  
Billing Zip Code:  
Expiration Date:    
Signature:  
 
If you are making payment by check or money order, please make it out to Educise Resources, Inc., and send it to Educise Resources Inc.  PO Box 1480  Massapequa NY 11758. Completion of the Signature field authorizes Educise Resources Inc. to submit credit card payment for the products selected.