Name____________________________________________________________________________________________

Address__________________________________________________________________________________________

City, State and Zip Code______________________________________________________________________________

Contact Phone Numbers and Best Time___________________________________________________________________

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TERMS:-->>Cashiers Checks or Money Orders in Full with Order. -- UPS...$10. -- OVERNIGHT...$25.-- FED-EX
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LEVEL - ( ONE ): Coastal Vacation Package includes: Leatherette Case, Lifetime Yearly Renewable Membership Cards,
$4000. in Discount Air Travel, ( THREE ) Luxury Cruises, 20 Bonus Vacations, Luggage and More.

Level ( ONE ) - Qty__________________X $ 1, 2 9 5 . 0 0 U.S. Funds Total $_______________________

LEVEL - ( TWO ): Three Day Seminar on Finance, Motivation, Travel, E t c.....

Level ( TWO ) - Qty__________________X $ 3, 5 0 0 . 0 0 U.S. Funds Total $________________________

PREMIER PACKAGE: Purchase Level ( ONE ) and Level ( TWO ) Together. ( Save $ 800.00 )

PREMIER PACKAGE Qty__________________X $ 3, 9 9 5 . 0 0 U.S. Funds Total $________________________

S U B T O T A L $__________________________________________

A D D + F R I E G H T ( U.P.S. $ 1 0. 0 0 ) or ( F E D - E X $ 2 5. 0 0 ) $________________________

T O T A L - B A L A N C E - D U E $____________________________________________

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MAKE CHECKS PAYABLE TO:>>>YOUR NAME HERE >>>FULL ADDRESS HERE

CITY >>> STATE >>> ZIP >>> 800 PHONE NUMBER >>>FAX NUMBER

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