Please enter the information below, to send with your check.

(When we receive your check, we will contact you to setup an appointment. Please note that this is all dependent upon a good, working, correctly entered email address.)

Please fill in these blanks:

First Name: _______________________

Last Name: _______________________

Country: _______________________

Telephone: _______________________

 Total Amount PrePaid:_______________________

    Email Address:  _______________________

                                    (Is that email address correct? Please be certain!)

Please verify that the information you entered is correct.  Please print this page on your printer and then enclose it in an envelope with your check for the prepayment amount (made out to "Dr. Vijai Sharma")   and send to:

Mind Publications Inc.,
3250 Blueberry Hill Place
Cleveland, TN 37312

When we receive your check, we will confirm receipt.

And that's it!  We're done. Thank you!

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