Just print out this form, complete it, and send or fax it to the address below together with the appropriate payment or credit card information to apply for a subscription, back issue or reprint. We also accept bank transfers in dollars or Japanese yen (contact us for instructions), but will only invoice for amounts of $700 or more accompanied by a purchase order. PLEASE PRINT.
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____ SUBCRIBE: Yes, we want to succeed in Japan. Send us ____ one-year subscriptions to SUCCESS STORIES: JAPAN for the executive subscription price of US$545 or JPY 54,500 each (US$595 outside the USA), a 31% savings from the US$795 regular price. Or for US$495 if I'm affiliated with an educational or non-profit institution.
____ BACK ISSUES: I'd like to order ____ copies of the _________ issue of SUCCESS STORIES: JAPAN. If I'm a subscriber, I agree to pay US$59 per copy, or US$29 per copy if affiliated with an educational or non-profit institution. If I'm not a subscriber, I agree to pay US$199, or US$99 if affiliated with an educational or non-profit institution (and the $199/$99 can be credited towards the full subscription price if I subscribe within 30 days). In all cases, a 10% discount applies to all orders of 3 or more back issues ordered at the same time.
____ REPRINTS: I'd like to order ____ copies of the _________ issue of SUCCESS STORIES: JAPAN that profiled our company. I understand that the minimum order is US$750 for 100 copies, and US$2 for each additional copy.
____ Enclosed please find my check or money order (payable to Success Stories Media, Inc.) in the amount of $__________.
____ Please bill my credit card for $___________: Mastercard Visa (Circle One)
Name as it appears on card:__________________________Expiration:___________
Credit card number:________________________Signature:_____________________
Mr. Mrs. Miss (Circle One) NAME:__________________________________________
HOW DID YOU HEAR ABOUT US? ________________________________________
SUCCESS STORIES MEDIA, INC.
163 Amsterdam Avenue, Suite 222
New York, NY 10023 USA
Fax this form to (212) 579-3785 in the USA, then send an e-mail to Japan@SuccessStories.com to confirm we've received the fax.
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