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Billing Information
 Shipping Information
*First Name
*Last Name
*Address1
Address2
*City
*State
*Zip Code
*Your email address:
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*Phone
Credit Card
*Card Number:
*Expiration Month:
 Expiration Year:
Card Verification Number:
Same as Billing Information
First Name
Last Name
Address1
Address2
City
State
Zip Code
PayPal EZPay 24 Month Subscription Plan

The monthly payment for this plan is $19.95 per month for 6 months.  When you
place your order and you apply for the paypal payment plan you will have the
option of paying by credit card or using a PayPal account to pay.  The first
payment will be billed at $19.95 +  $98  S&H      The balance of the order will be
charged  $19.95 per month for 23 consecutive months.

Late payments caused by declined payment attempts may be subject to a late
payment fee. If a subscription is cancelled for any reason the full amount of the
balance of payments will be due.

By pressing the accept button below you agree to the terms of the installment
plan order.
HF015AD HealthMax Pro