Journey To The Infinite

Mail Or Fax In Your Order

Please print out the following order form and either:

1. Fax it to (434) 978-0118

2. Mail it to:

Ultimate Lifestyle Academy
690 Berkmar Circle
Charlottesville, VA 22901

Please fill in the checkbox at the left and quantity box at the right for the number of seats you'd like to reserve:

*	Event Description	Quantity
	*Journey To The Infinite -- Full Expression of Appreciation* -- $500 (plus shipping and handling)

U.S. Delivery
Full Expression of $515 ($500 + $15 shipping and handling)

Canadian Delivery
Full Expression of $535 ($500 + $35 shipping and handling)

Other International Orders
Full Expression of $560 ($500 + $60 shipping and handling)

I prefer to enroll by check:
I'm enclosing a check or money order, made out to "Ultimate Lifestyle Academy," for the total expression of Appreciation shown above.

I prefer to enroll using my credit card (please check one):

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Expiration Date: ____________________________________________

Security Code (3-4 digit on ront or back of card) _____________________

Authorization:
I authorize The Ultimate Lifestyle Academy to charge my credit card as specified above for the Journey To The Infinite Home Transformational System specified above.

_________________________________________________
(please sign your name above)

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