For a secure online order form click here: http://www.cancerbook-tj.com/order.html
*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:
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E-MAIL:
STOP HERE IF YOU SENT
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NUMBER:
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Discover, sorry NOAmerican Express taken)
EXPIRATION
DATE:
3 DIGET SECURITY CODE
ON BACK:
NOTE: OR YOU CAN MAIL
ME A MONEY ORDER TO THIS ADDRESS:
Tommy Johnson
Sr.
126 Red Brook
Lane
Mooresville, N.C.
28117
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.
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