Order Form

Books cost $17.00 each.  (Includes shipping and handling).

Name:__________________________________

Address:_________________________________

City, State, Zip:____________________________

Phone home:___________________________________

Cell phone:___________________________________

E-mail:_______________________________________

Number of copies ordered:

Why Won't You Listen To Me! _____

A Better Way To Live Life! _____

The Eight Basic Psychological Needs _____

10% discounts for Promo Codes.    Promo Code __________

Amount enclosed or charged: $___________

Make checks or money orders to: JF Associates

Circle One:  MasterCard   Visa   or   Discover Card

Card Number:____________________ Exp. Date:_________

Send to:

Charles Jackard

3221 W. 83rd Street

Shawnee Mission, KS  66206

Tel/Fax (913) 648-7039

E-Mail: snooper@qni.com