Subscription Application Form


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Secure Subscription Form

We respect your privacy. The personal information requested below is for use in processing your credit card, which is done with secure encryption. We never reveal, share, or sell member information. For complete details see our Privacy Statement.

Customer Information

* = Required - Must match credit card billing address!

First Name [ required ]
Last Name [ required ]
Company
Address Line 1[ required ]
Address Line 2
City [ required ]
State [ US & Canada ]
State/Province [ All other Countries ]
Zip/Postal Code [ required ]
Country [ required ]
Your E-mail Address [ required ]
Phone or Fax Number [ required ]

Shipping Information

Shipping same as billing address

Ship To First Name [ required ]
Ship To Last Name [ required ]
Ship to Company
Ship to Address Line 1[ required ]
Ship to Address Line 2
Ship to City [ required ]
Ship to State [ US & Canada ]
Ship to State/Province [ All other Countries ]
Zip/Postal Code [ required ]
Ship to Country [ required ]

Subscription Options

Monthly Subscription Plan options:	Standard MONTHLY membership $39/month (includes FREE "Mastermind" call) $39 One-time Registration (normally $99) Automatic $39 renewal - Your credit card will be charged every month. Cancel anytime by e-mail. "Deluxe Training DVD" MONTHLY membership EVERYTHING above PLUS one Training DVD for $35 more (normally $87) Automatic $74 renewal - Your credit card will be charged every month. Cancel anytime by e-mail.

Quarterly Subscription Plan options:	Standard QUARTERLY membership 15% SAVINGS by paying for the quarter in advance ($33/month fee) $39 One-time Registration (normally $99) FREE access to our Monthly "Mastermind" call. Automatic $99 renewal - Your credit card will be charged every three months. Cancel anytime by e-mail. "Deluxe Training DVD" QUARTERLY membership EVERYTHING above PLUS THREE (3) Training DVDs for $30 each (normally $87 each) Automatic $189 renewal - Your credit card will be charged every three months. Cancel anytime by e-mail.

Yearly Subscription Plan options: (Best value)	Standard YEARLY membership 36% SAVINGS by paying for the year in advance ($24.92/month) $39 One-time Registration (normally $99) FREE access to our Monthly "Mastermind" call. Automatic $299 renewal - Your credit card will be charged every year. Cancel anytime by e-mail. "Deluxe Training DVD" YEARLY membership EVERYTHING above PLUS TWELVE (12) Training DVDs for $25 each (shipped monthly, normally $87 each) Automatic $599 renewal - Your credit card will be charged every year. Cancel anytime by e-mail.

Choose LOGIN Name [ required ]

Choose PASSWORD [ required ]at least six characters long, using alphas and numbers, no spaces.

Confirm PASSWORD [ required ]

Payment Information

Payment Method [ required ]
Credit Card Number [ required ]
Credit Card Security Code [ required on (MC/Visa/AMEX) ? ]
Expiration Date [ required ]	/
Name on Credit Card [ required ]
Is this a Renewal?
Do you wish to receive email alerts?
<<< Please Check The Box to acknowledge that you have read and understood our terms of use.


NOTE: It can take up to a minute to process the credit card information and obtain approval. Please do not press the submit button multiple times - doing so could cause double billing.
For the protection and privacy of our visitors and customers, as well as the security of the server, suspicious activities on our site are monitored, tracked and reported.