HSL International Harry Schultz Letter

 

SECURE ORDER FORM
GCRU
via Mail, Fax or Submit

1) Please fill out the following form.
2) When finished, to mail or fax, print this page out and Fax it to:
+506 2272-6261
OR
    mail it to HSL, Apartado 775-2300, Curridabat, Costa Rica
   (Please make check payable to: MAP Customer Service S.A.)


Subscriptions are neither assignable, nor refundable (this includes lifetime subscriptions).

Is this a NEW SUBSCRIPTION or RENEWAL ?



Via Email

Via Fax

  3-month
US$300 or €251
US$420 or €351
 6-month
US$585 or €489
US$825 or 671
9-month
US$855 or €715
US$1,215 or 1,015
 12-month
US$1,110 or €928
US$1,590 or 1,328
Please choose your subscription period: 

Credit Card Type:     Credit Card #:     

Valid thru:  Mo.     Year:
       
*Attention Credit Card Holders: Please provide the last three digits (preceded by a space) of the number appearing in the signature area on the back side of your card.
CVV2#
 

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Page 2

Actual Subscriber's Name & Address:

 
First Name: 
 Middle: Last Name:  
Address: 
   City:
  State: 
    Zip / Postal Code:  -
Country:
Email: 
Telephone: 
Fax: 

Name & Address of Credit Card Holder, if different from above:

First Name: 
 Middle: Last Name:  
Address
 City:
  State: 
  Zip / Postal Code:  -    
Country:

      

                    

If you have any questions, please contact:
hslmentor@racsa.co.cr
Tel: +506 2271 2293  Fax: +506 2272 6261
From N. America dial 011 first, 00 from elsewhere

MAP Customer Service S.A. / P.O. Box 775-2300 / Curridabat, Costa Rica