Tom Danley

Tom Danley's "Tape of the Month"
Subscriber Application form for Credit Card payment only.
Print This Application and fill in the requested information. Please Print.

Name_____________________________________________________________________

Social Security or Tax ID# ______________________________________(US & Canada Only)

Mailing Address ____________________________________________________________

City ___________________________ State _______________ Zip__________

Country _________ Email Address ____________________________ Phone # ___________

Your Choice: Tape_________ or CD_________

Sponsor Name: George Carpenter Sponsor ID #: 19172

The first payment is $36. ($25 pays for your first tape or CD, $1 Processing fee, and $10 pays for your business start up kit from Tom Danley Co.)

I would like to charge $36 one time to my: MASTERCARD____ VISA____

Name on Card: _____________________________________________________________

Credit Card #: ___________ ______________ ___________ ___________

Expiration Date: ____________________________

Signature ________________________________________ Date _________________________

If you intend to pay your monthly subscription fee for Tom Danley’s “Tape of the Month” by sending in a check or Money Order monthly. Please note that the subscription fee is due by the 1st of each month. Complete the following to pay your monthly subscriber fee automatically each month. This option is highly recommended.

Complete the following to pay your monthly subscriber fee automatically each month.

Additional, I hereby authorize Tom Danley Companies to debit the designated credit card account for my monthly payment of $25.00, plus a $1.00 processing fee, on the 1st day of each month. Total $26.00 monthly until I cancel in writing.

Signature ________________________________________ Date _________________________

Mail This completed form and payment to: Profit First with Front Money, W261 S8300 Faulkner Rd, Mukwonago, WI 53149