This order form allows customers to purchase booklets from Louise Hayes for $12 each on various self-improvement topics like brain growth, learning ability, and stroke recovery. The customer fills in the number of copies wanted for each booklet title and returns the form with payment to Louise Hayes' Houston address. The form thanks the customer and has a space for them to calculate their total order amount.

1. Order form for your convenience.
Please complete and send with check or money order to
Louise Hayes, Ph.D.
7934 Turquoise Lane, Houston, Texas 77055-1517
Booklets Available, $12 each (Includes S&H)
Each booklet describes what is to be accomplished, the
procedures to be used, why they work, and detailed instructions.
Brain Growth how many copies ___ $___
Improve Learning Ability how many copies ___ $___
Whole Brain Study and
Test Taking how many copies ___ $___
Stroke Recovery how many copies ___ $___
Language Delay how many copies ___ $___
Pain Release how many copies ___ $___
Improve Vision how many copies ___ $___
Balance, Gait, Posture,
and Back Comfort how many copies ___ $___
Better Athletes how many copies ___ $___
Thank you! Total
$____