Fighter Pilot Power Pack Order Form
 Click To Print This Order Form

Print this form and fax or send your shipping and payment information to:

Mail:   Ed Rush & Associates          OR              Fax: (619) 292-2598
            P.O. Box 1290
            Bonita, CA 91908


First Name:
 ____________________________________________
Last Name:
 ____________________________________________
Shipping Address:
 ____________________________________________
____________________________________________
City:
 __________________ State: _____ ZIP: _________
Telephone:
 __________________
E-mail:
 ____________________________________________
 
Number of Packs:
 ____ Pack(s)
$106.95 per pack ($97 + $9.95 Postage)
   
Afterburner Club:
1st Month Free and then I will automatically be signed up for the Afterburner Club hosted by Ed Rush at the special price of $37 per month until I cancel. (Credit Card Orders Only)
 
Method of Payment:
 Visa _____ MasterCard _____ Discover _____
Check_____ Money Order _____
Make checks and money orders payable to: Ed Rush & Associates
   
Credit Card Number: ____________________________________________
CVV: _____________ (3 digit security code on back of card)
Expiration Date: _____________
Name on Card: ____________________________________________
   
Billing Address: ____________________________________________
(if different than above) ____________________________________________
City: __________________ State: _____ ZIP: ________
   

If you have questions or would like more information about the Fighter Pilot Power Pack,
please call us toll-free at (619) 292-2599.
www.becomefighterpilot.com