Simple Golf Mail-Order or FAX Form

To order by sending us a check, money order, or cash, please complete the following easy steps:

1) Print out this page, or write out the information if you do not have a printer

2) Fill out sections 1 and 2

3) Using section 3, calculate your total price.

Include a check or money order made out to "Simple Golf " for that amount.

4) Mail the completed form and your payment below address.

5) Fax option - Fill out Section 1 and 2 and fax to the below number and include your credit card information.

Simple Golf LLC –

26 Maplewood Drive Danbury, CT 06811-4211 Fax 425-928-2362

Section 1: Check the video title(s) you are ordering:

____ Symple Swing Short Game DVD - $24.99

____ Full Symple Swing DVD - $29.99

____ Symple Putting DVD - $29.99

____ Symple Swing Power Tips DVD - $29.99

____ Symple Swing Advanced Drills - $29.99

____ Symple Swing Power Playing Lesson Part 1 DVD - $29.99

____ Symple Swing Power Playing Lesson Part 2 with Student Lesson DVD - $29.99

Section 2: Enter your information

Name _______________________________________

Street Address:_______________________________________

City, State (or Province) & Zip:_______________________________________

Country: _______________________________________

Email (to email you a tracking number):_______________________________________

Phone Number:_______________________________________

How did you hear about us?_______________________________________

Section 3: Calculate your total price:

Video(s) $ ____________________

S & H $7.95 ____________________

Total ____________________

Credit Card Information

Card type: ___________________ Expiration Date: _____________

Account Number: _______________________________________________

Cardholder's Signature: _______________________________________

Cardholder's Name (as shown on card): ____________________________________________

Inside the USA? Express Mail Shipment is available. Add $10.00 for quicker delivery.

Outside the USA? Add $5.00 for International shipping fees.

With money orders and credit card orders, we will ship immediately. With checks, we wait 7 days for them to clear.

Payment in US dollars only. Money Orders are okay although we may hold the order until the order until the money order clears. No other currencies accepted.

You can mail this form to:
Simple Golf LLC, 26 Maplewood Drive, Danbury, CT 06811-4211

Or fax this form to 425-928-2362