PSP (1st Choice) Fax/Mail Order Form

P.O. Box 631639, Irving, TX 75063 - Phone: Fax/Voice: 1-407-650-2568

SHIP TO: (no post office boxes, please)

PAYMENT METHOD:

Name:________________________________

Check:___     Amt. enclosed:$___________

Company:_____________________________

Money Order:___ Credit Card: MasterCard  VISA

Address:______________________________

Card Number: _________________________Exp._______
Address:______________________________

Signature:___________________________

City:___________________ State:_________

Phone Number  (____) -______-_________
Zip:________________  Email Address; ______________________

1st Choice Seen On TV Products        A Division of Profit Source Publishing

Just print out this form, fill in the details and mail or Fax it to us.

*** Make Check Or Money Order Payable To: Profit Source Publishing ***

Item Number

ITEM DESCRIPTION

Color/ Size/ Style

QTY

Price

TOTAL AMOUNT

. . . . $ $
. . . . $ $
. . . . $ $
. . . . $ $
. . . . $ $
. . . . $ $
        $ $
        $ $
        $ $
        $ $
        $ $
        $ $
        $ $
. . . . $ $

Shipping&Handling Charges
$5.90 + 20% of SubTotal
(US Shipping Only)

SUBTOTAL $
Shipping&Handling Charges $

( FL residents add 6% sales Tax )

FL Add 6% Tax $
  TOTAL DUE $
Note: Most Items are shipped USPS Date: .

*** Make Check Or Money Order Payable To: Profit Source Publishing ***