Fill out this Order Form to purchase the JES Extender via the Internet, or read the information below for alternate methods of payment.

The price for the JES Extender is U.S. $ 990.00 including shipping and handling.

Your merchandise will arrive within 15 working days, with a 12 month international guarantee, and two week money refund. Money refund is excl. shipping.

Every aspect of ordering and shipping will be handled with the utmost discretion.

First Name:
Last Name:
Address:
City:
State:
Zip:
Country:
E-Mail: Telephone: (Required on all credit card orders.)

Credit card type:

Name on the card:

Card Number:

Expiration Date (month/year):

By clicking on the submit Order Form button below, I hereby certify that I order the JES Extender and I am 21 years of age or older.

To submit your order, press this button:
To clear the form, press this button:


Alternate method of payment.

If you prefer not to pay with a credit card, you can also use international money order or personal check (enclosed). Make it payable to :

DanaMedic
P.O. Box 12733
Raleigh, NC 27605

Print Order Form