Please Print Clearly: Complete, Sign and Fax to: +852-2869-6903

To: Iso Fit-On behalf of Polestar Pilates Asia Inc.

Please debit my credit card (Master/Visa only) for US$_________

In words: US$_______________________________________________

For:  

My Credit Card Details are as follows:
[ ] Master Card          [ ] Visa

Credit Card Number: _  _  _  _ / _  _  _  _ / _  _  _  _ / _  _  _  _

3 Digit Security Code:_ _ _        Expiry Date: (mm/yy): _ _ / _ _

Name on Credit Card:_______________________________________

Signature as appears on Credit Card: ___________________________