Credit Repair Kit

Mail Order Form
Amount $46.90 ($39.95 + 6.95 S&H)
Please TYPE your information into this form, then print it.
We do NOT accept hand written orders.
Billing / Shipping Information
First Name M. I. Last Name
Address:   Street Number Street Address - Apt / Ste #
City State Zip Code

Phone Fax  (optional)
    
Please include area code. (Example: 123-456-7891)
Email Address
   
Please use a valid email address so our system can send you a reciept.
AOL Users please use your complete address.   Ex. YourScreenName@aol.com
Choose Your Payment Method
Pay by Credit Card via Fax or U.S. Mail
Credit Card Type Credit Card # Expiration  Date
  
 
Pay by Check or Money Order via U.S. Mail
Check or Money Order for $46.90 made Payable to: PCmailer.com, Inc.
 
Print This Form, Mail it or Fax it, along with your payment to:
   
  PCmailer.com, Inc.
  Dept ( 1 )
  1734 Clarkson Road #101
  Chesterfield, MO 63017