Mind Training for Swimmers Full Membership + Swimmers Ebook Program Print out this order form and: Send it by 'snail mail' - Please Note: Checks require an additional $5 bank processing fee - to: It's Mind over Matter PO Box 106 Belrose West NSW Australia 2085 (please note mail may take at least one week to be received through international mail). Checks require an additional $5 bank processing fee, & may be made out to: "It's Mind Over Matter".

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Please send me the Full Membership + Swimmers Ebook Program - as soon as you have received my payment!

Name (block letters): _________________________________ (Note:exactly as on card - if using this for payment)

Email: ___________________@________________________
(please check spelling / print clearly)

Email check: ___________________@________________________

Company (optional): _______________________________

Address (block letters): ______________________________

City (block letters): ________________________________

State: ______________

Country (block letters): _____________________________

Zip: ________________     Phone: (_____) ________ - __________

(  ) I am enclosing a check or money order for USD$29.95 - PLUS an additional $5 bank processing fee.

(  ) I wish to charge this purchase to my Credit Card for USD$29.95

Credit Card (check one):

(  ) VISA      (  ) MasterCard      (  ) Delta         

Card Number: _________-________-_______-__________

Expiry Date: _______/________

Security Code (required for Visa cards only - the last 3 no.s on the back of your card) ___ ___ ___

I hereby authorize It's Mind over Matter to charge USD$29.95 to my credit card for the purchase of Full Membership + Swimmers Ebook Program.

Signature: ____________________________________

Your purchase will be sent to you as soon as payment is received.

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