Penis Enlargement - no surgery or drugs and works every time

SALE
All Devices Discounted
25%

Order Form

This form can be sent via the net (by pressing the "Submit This Form" button below). However, if you prefer to mail it in, please use our printable order form.

If you have any questions, please call us at 1-732-657-7434 between 9 a.m. and 5 p.m. EST.

Pricing for the Circle Device is as follows:

12 oz, now 3/4 inch long - $100.00 ($US); SALE PRICE = $75.00
16 oz, now 1 inch long - $135.00 ($US); SALE PRICE = $101.25
24 oz, now 1.5 inches long - $225.00 ($US); SALE PRICE = $168.75
32 oz, now 2.0 inches long - $300.00 ($US); SALE PRICE = $225.00

Each order contains:

1 Device (sealed in a plastic bag)
A velvet string pouch to store your Device
Full, simple instructions
5 elastic bands
Instructions on exercises that will increase hardness and girth of the erect penis

All orders are shipped within 24 hours of receipt of payment, in a discrete package, via first class mail.

We accept a certified bank check or money order (no personal checks), or one of the following credit cards:

1) Determine sizing and fill in the chart below.

If you need a tapered device, please put the two measurements requested in the second column below.
Tapered devices cost an additional $20.00 for the 12oz or 16oz, $40 for the 24oz and 32oz.
Yes, I need a tapered device and will pay extra for it (them)

Note:

Any device can vary up to 15 grams in weight, due to customizing.
Any device over 5.0 inches in circumference will cost an additional $75.00
Yes, i need devices over 5" and will pay extra for it (them).
Any device returned for adjustment requiring more than 1/8" adjustment will cost $25.00 plus shipping
(see shipping charges below).

Qty	Circumference of flaccid (soft) penis; 3" minimum	Device
		12 oz
		16 oz
		24 oz
		32 oz

2) Fill in the form:

First Name :
Last Name :
Shipping Address :
Shipping Address :
City :
State/Prov. :
Zip Code :
Country :
Telephone Home*:
Telephone Work*:
Fax*:
E-Mail :
Credit Card Billing address, if different than the shipping address:

* For international numbers, please include country code.

3) Payment Information:

Note: • All monies are in US$. • If paying by credit card, please fill in your billing address above. • All orders within the U.S.A. are shipped U.S.P.S. Priority Mail, Confirmation Delivery. Upon credit card approval, you should receive your order within 5 days within the U.S.A. Shipping charges within the United States are $6 for the 12 oz and 16 oz Circle Device and $13 for the 24 oz and $15 for the 32 oz Circle Devices. • All orders outside of the U.S.A are shipped via Express Mail, which should be within 8 days. Shipping charges for outside the USA are all $30, regardless of weight. For shipment outside the US, orders must be paid by credit card as this eliminates foreign country money differences and collection of monies that can hold up shipment of our product. • NJ residence must pay a 7% sales tax.
Credit Card Type:	Card Number:	Exp. Date:
Security Code (3 digits on back of card). Required field:
Card Holder's Name as it appears on your card:

4) Please fill in some marketing information:

Where Did You Hear of Us?:	Please elaborate (e.g.: which magazine did you see our ad in; if searching on the Net, what Search Engine and keyword did you use; etc.):
Comments or Questions:

5) Fill in the totals: Note: all monies are in US Dollars

Device(s) Cost:		12 oz: $75.00 16 oz: $101.25 24 oz: $168.75 32 oz: $225.00
Tapering Cost:		12 or 16oz: $20.00 24 or 32oz: $40.00
Extra Cost for devices over 5" in circumference:		$75.00
Shipping Charge for EACH device:		Within USA: 12 or 16 oz: $6.00 24oz: $13.00 32oz: $15.00 Outside USA: $30.00
NJ Res. only Sales Tax (7%):		12oz: $5.25 16oz: $7.08 24oz: $11.81 32oz: $15.75
TOTAL PAYMENT:		US$

6) Please choose one of the next three options:

For credit card orders you may Order on-line. Press...
to start over, press...

THANK YOU

Due to the nature of the Circle Device,
IT IS NOT RETURNABLE.

A charge of $10.00 will be charged
for shipping and handling for any adjustment work

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penis lengthener

ORDER Today!

International and US customers welcome!

Please send us any questions or suggestions you may have -- they are always welcome. All inquiries are kept confidential.

For free printed information: you can either print these pages using your browser's print command or send a self-addressed stamped envelope to us.

The Circle Device is patented; any infringement of its design and intended use will be prosecuted by law.

Last updated 8/25/2010