Application for 12 Month Marketing Mastery Program

Please accept this application as my official indication of interest and let me know if I’m accepted as soon as possible.

Please note that your information is saved on our server as you enter it to assist you with your submission.

Name(Required)

Company Name

Address(Required)

Street Address City / Town Province / State Postal Code / Zip Code Country

Telephone(Required)

Email Address(Required)

Website

Please describe your business as it is today (include how long you’ve been in business, your current products and services).(Required)

What are you currently doing to market your business?(Required)

What 3 successes do you most want to accomplish in the next 12 months?(Required)

Who or what do you think is responsible for your current results?(Required)

What is your long-term vision for your company – and for you?(Required)

What personal and/or business development program(s) have you studied before?(Required)

What are the 3 challenges you would like to overcome to achieve your goals?(Required)

What new or expanded products/services would you like to introduce in the next 12 months?(Required)

Anything else you’d like to share when being considered for this program?

Payment Procedure

12 Month Marketing Mastery Program with Susan Regier
$15,000.00 + HST (where applicable)

OPTION 1: I’d like to pay in full and save $1250.00 (one month fee)! The cost will only be $13,750.00 plus HST (where applicable).

OPTION 2: I’d like to take advantage of the 12 easy payment plan. I will make 12 monthly payments of $1,250.00 (plus HST where applicable).

All fees are non refundable and non cancellable.

NOTE: Payment available by cheque, e-transfer, or credit card. Please let us know your preferred payment so we can bill accordingly.

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Thank you for your application. I will personally review it and contact you within days to let you know if you are approved.

To your success,

Earnings/Income Disclaimer Confidentiality Agreement

There can be no assurance that any prior successes, or past results, as to income earnings, can be used as an indication of your future success or results.

Monetary and income results are based on many factors. We have no way of knowing how well you will do, as we do not know you, your background, your work ethic, or your business skills or practices or risk tolerance. In fact, you may lose money. Therefore, we do not guarantee or imply that you will get rich, that you will do as well, or make any money at all. There is no assurance you’ll do as well. If you rely upon our figures, you must accept the risk of not doing as well.

Our products may have unknown risks involved, and are not suitable for everyone. Making decisions based on any information presented in our products, services, or Web site, should be done only with the knowledge that you could experience significant losses, or make no money at all.

All products and services by our company are for educational and informational purposes only. Use caution and seek the advice of qualified professionals. Check with your accountant, lawyer or professional advisor, before acting on this or any information.

Users of our products, services and Web site(s) are advised to do their own due diligence when it comes to making business decisions and all information products, and services that have been provided should be independently verified by your own qualified professionals. Our information, products, and services at this event should be carefully considered and evaluated before reaching a business decision, on whether to rely on them.

You agree that we are not responsible for the success or failure of your business decisions relating to any information presented by us, or our company products or services.

The information in this program, written and verbal, is confidential and cannot be duplicated in any form.

Name(Required)

Signature(Required)

Date(Required)

Confidential Application for

12 Month Marketing Mastery Program

with Susan Regier

Payment Procedure

12 Month Marketing Mastery Program with Susan Regier $15,000.00 + HST (where applicable)

Earnings/Income Disclaimer Confidentiality Agreement

12 Month Marketing Mastery Program with Susan Regier
$15,000.00 + HST (where applicable)