Interactive Multimedia International Information Pack Order Form

The Earth Turns - it's your turn now!

    Our company opens in several countries a year to develop our successful business. Your country could be the next one to open and you can take advantage of this unique situation! (Countries can open only once in our industry.)

    The Interactive Multimedia International Information Pack will enable you to start developing the market in your country and prepare you to belong to an exclusive group of wealthy leaders. Our experience in 36 countries confirms this fact.

    The Interactive Multimedia International Information Pack costs US$15.00, including air mail postage to your door. We will also inform you immediately when you become eligible to purchase the International Work-At-Home Business Package.

Name:
Street Address:
City: State: Postal Code:
Country:
Daytime Telephone:
Evening Telephone:
Best time of day to reach you: 

E-mail Address:
(This is very important - we cannot send any information without a valid e-mail address! )

Does your Internet Service allow you to receive attachments to your e-mail messages?Yes No

Would you prefer that we send you the Interactive Multimedia International Information Pack as an attachment to an e-mail message or by air mail?
E-mail Attachment:       Air Mail:
 

Please use the text area below to tell us about yourself:

What is your primary language?

Which other languages do you know?

Do you have relatives, friends or acquaintances in any of the other countries on our Home Page? Yes No

 Your Current Occupation:
Male Female
Age:

 
Credit cards
 
What means of payment do you choose?
(Our site uses secure server technology [SSL] for orders.)
Visa        Amex        Master Charge        Diner's Club
Your Credit Card Number is:
Your Credit Card Expiration is (mm/yy): 
International Bank Check
Please note that your information will not be sold to anyone or used for any other purpose.
 
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Updated: 9January 1999
Copyright ©1999 by Bird Communications —  ALL RIGHTS RESERVED