Enrollment (Pro Consultant)

PERSONAL INFORMATION

Name *

First

Middle

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Confirm Email

Cell Phone *

Home Phone

PRO CONSULTANT CONFIRMATION DETAILS

Date of Birth *

Example: MM/DD/YYYY

PAYMENT INFORMATION

You'll only be charged $189.98 today.
This includes a 50% discount on the $99 per year (only $50 today) plus your first and last on the $69.99 monthly subscription.
In other words: $50 today + $69.99 first + 69.99 last = $189.98 Total Paid Today.
Each year, on the anniversary of your enrollment, you'll automatically be charged a $99 renewal fee to keep your account active, billed to the credit card you provide today.
Your monthly subscription price is $69.99 per month starting your second month, billed to the credit card you provide today, until you cancel. You can cancel anytime by calling (833) 848-5433.

Credit Card Number *

Name On The Credit Card *

Expiration Date *

Example: 10/25

CVV *

The 3 or 4 digit code on the back of the Credit Card

Is The Billing Address The Same As Above? *

CONFIRM CURRENT & RECURRING FUTURE PAYMENTS

You'll be charged $189.98 today. This includes a 50% discount on the $99 per year enrollment (only $50 today) plus your first and last on the $69.99 monthly subscription. Each year, on the anniversary of your enrollment, you'll automatically be charged a $99 renewal fee to keep your account active, billed to the credit card you provide today. Your monthly subscription price is $69.99 per month starting your second month, billed to the credit card you provide today, until you cancel. You can cancel anytime by calling (833) 848-5433. *

I Agree

Enrollment Confirmation Disclaimer and Acknowledgement *