Optimum Performance Training 
  
 
  To order services please fill out this form completely, any blank fields may delay your order. 
Once the form is complete you can submit it by simply pressing the submit button.		  
 
 
 
 
  Company Information (Red text denotes required information)  
 
 
 
  Name:    
   
 
 
 
  Street Address:    
   
 
 
 
  City, State, Zip:    
   
 
 
 
 
   
  Email:     Phone:  
 
 
 
 
  Order Calculation:                 Quantity               Subtotal
 
Plyometrics Video....................................... x $39.95=  (Add $5.00 for Shipping)   
   
 
  Strength Training Video............................... x $39.95= (Add $5.00 for Shipping)  
   
 
   Warm-Up and Flexibility Manual................ x $19.95= (Add $3.00 for Shipping)  
 
  .  
                                                         -OR-  
 
  Plyometrics and Strength Training Videos ...  x $64.95= (Add $5.00 for Shipping)     
   
 .
               Entire Package: Both Videos and     
                 Warm-Up and Flexibility Manual...............   x $81.95=  (Add $6.00 for Shipping)  
   
 
     
                                            Total Order  
   
 
  Please type any shipping instructions.  
 
   
 
 
 
           Credit Card Number                            Credit Card/Expiration  
 

       Payment Instructions
  Upon acceptance of your application an invoice will be sent to you. If you would rather pay by mail, simply print out this page, and send a check or money order to the following address:  
 
               Optimum Performance Training    
               P.O. Box 395
               Uwchland, PA 19480-0395