VISIONARY DVD CLUB
Subscription Form
Print out this page, fill out this form, and fax or mail this sheet to start your service
(or call us with the numbers, etc. PDF version)
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The Message Company
4 Camino Azul
Santa Fe, NM 87508 USA
Email: signup@visionarydvdclub.com
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505-474-0998
505-474-7604
Fax: 505-471-2584
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Please charge each month's shipment to my credit card:
Please Print Clearly * indicates REQUIRED FIELD
*CC# ______________________________
*Expires ____________________
*Signature ______________________________________________________
*Your Name on Card _____________________________________________
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Billing Address:
*Name _______________________________________________________
*Address _____________________________________________________
______________________________________________________________
*City ________________________*State __________ *Zip ___________
*Phone _________________________ Fax _________________________
*Email________________________________________________________
 Yes! Sign me up for the Visionary DVD Club. Iunderstand that my credit card will be charged $20 each month for this service. I understand that I may cancel this service at any time. (If shipping is to a non-USA address, I authorize US $27 per month.)
Shipping Address if Different:
Address________________________________________________________
City____________________ State__________________ Zip______________
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"I am so very, very pleased to be a part of this, feeling all this energy, receiving so much, and experiencing so much synchronicity. It’s just amazing, and I am most grateful."
— Barbara Holland
(Our DVDs do not have any regional coding so they may be played on any DVD player.)
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