Customs Review Order Form
Customs Broker License Video Course

Please print, complete and mail or fax this form to the following:

Fax:
305-477-9881

Mail:
Customs Review
1867 NW 97th Ave. Suite 101
Doral, FL 33172

COPYRIGHT NOTICE: (signature required below)
All the information included in this course is yours to keep. This entire course including, but not limited to, the Video Lecture, Study Guide, Reference Material and method of instruction has been copyrighted by Customs Review Inc. All rights reserved. Customs Review Inc aggressively defends its rights under these laws and no part of this course may be copied, reproduced or transmitted in any form (electronic, photocopying, recording or otherwise) without the prior written permission from Customs Review Inc.

I have read the copyright notice and agree not to violate any copyright laws.


Signature________________________________________

Enrollment and Registration Information

Name: _________________________________________________________

Address: ______________________________________________________

_____________________________________________________________
(We can not deliver to a PO Box.)

Daytime Telephone: ____________________________

E-Mail: ________________________________________

Fax (if applicable): _____________________________

I am ordering: (check all that apply, or write quantity desired)

  • ___ the DVD Video Course ($775.00) shipping included

Video price includes 2nd day air shipping for the continental United States. Other products shipped ground delivery. Orders outside the U.S. must add $70.00 or request freight collect.
Enclose a check or enter credit card information:

Check No. ____________ or Card Type _____________

Card No. __________________________________ Exp. Date _______________

I agree to pay for this charge according to my cardholder agreement.

Signature: ________________________________________________________

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