Order Form

For a secure online order form click here.

*If you mail a money order be sure to include this form after you've filled it out completely.

BOOK ORDER FORM

Price per book: $19.95 + $5.05 S&H (U.S. Funds)

(North Carolina residents state your county and the sales tax percentage for your county)

TODAY'S DATE:

NAME:

BILLING ADDRESS OR P.O. BOX:

CITY, STATE & ZIP:

SHIPPING ADDRESS IF DIFFERENT:

COMPANY NAME (If shipping to a business):

YOUR NAME:

STREET OR AVE.:

CITY, STATE & ZIP:

HOW MANY BOOKS WOULD YOU LIKE?

YOUR PHONE NUMBER:

YOUR E-MAIL:

STOP HERE IF YOU SENT A MONEY ORDER:

CREDIT or DEBIT?

CREDIT CARD NUMBER:

(MC/Visa or Discover, sorry NO American Express taken)

EXPIRATION DATE:

3 DIGIT SECURITY CODE ON BACK:

NOTE: OR YOU CAN MAIL ME A MONEY ORDER TO THIS ADDRESS:
Tommy Johnson, Sr.
445 Airpark Drive
Mooresville, N.C. 28115

DISCLAIMER: I'm NOT a doctor, I'm NOT practicing medicine, I'm NOT recommending anything, I'm NOT promising or guaranteeing anything, I'm NOT selling or promoting anything by my book that tells my true life story about my battle with cancer, the emotions I went through and what “I believe” put it into full remission when there was absolutely NO hope for me. Also WHY “I believe” that cancer will NEVER cured!

Tommy Johnson Sr.