MommyMaker, Fertility Prediction

FILL-IN MAIL ORDER FORM

Fill in all the necessary boxes then print this page out and mail it with a check made out to "Stratus" for the correct amount to the following address:

STRATUS
PO Box 11832
Atlanta, GA 30355

(if you are not able to print you may copy the information from this form to a blank sheet of paper and mail it in with a check)

YOUR MAILING ADDRESS AND CONTACT INFO

Name:

Street Address:

City:

State:

ZIP code:

Phone:

email:

I would like to register the following:

			AMOUNT
1 Copy of MommyMaker			$ 99.95
2 Copies of MommyMaker			$ 179.95
3 Copies of MommyMaker			$ 239.95
5 or more copies			$ 59.99 per copy

Make out check for the total amount for the order you have chosen or created above, payable to "Stratus".

Please double check all the information before you print this out and mail it in with your check.

Thank you for your business, we hope you will enjoy our products.

Name:
Street Address:
City:
State:
ZIP code:
Phone:
email: