FAX ORDER FORM TO: 800-397-3840
____Yes, I would like the free trial offer for your "Annuity Pro Lead Capture Web Page" for the first 30
days being FREE. After the 30 days you can bill my credit card monthly for $39.00.
UPGRADE TO GOLD PLAN -You'll receive a monthly ready-to-mail newsletter that you can personalize with
your picture and contact information. This 4 page "Stay -in-Touch" self mailer newsletter will be available
with our amazing affordable Internet Postal Mailing and Printing Service can put this on auto pilot for you.
It's designed to help you stay in touch with your prospects, current clients, past clients and center of
influences each month.
You can test a trial subscription for only $20.00 more per month. Several other Insurance marketing
Guru's sell their newsletter for $197.00 per month. So, my limit time price is a steal! Plus, you get
the first month FREE. In addition, you can cancel at anytime! So the total monthly investment
would be only $59.00 for the "Gold Package.". Listen closely, do you know anyone else on the
planet that is offering an Annuity Lead Capture Web Page, an automatic auto responder drip system
and your own personalized newsletter for only $59.00. I didn't think so!
Remember: Currently, our monthly "Stay-In-Touch" Newsletter is not sold separately, so you won't
be able to buy it later at this price. So, here's your chance to capitalize on this one time introduction
test offer.
___ Yes, sign me up now for the "Gold Package" which includes the monthly Client
Newsletter and our "Annuity Pro Lead Capture Web Page." FREE TRIAL! After the trial
period you can charge my Credit Card for $59.00. I understand I can cancel at anytime.
Need simple username extension for website like first name or initials_____________ password ______________
(Please Print Clearly)
Name: ___________________________ Phone: _________________________________
Address: ____________________________EMAIL: _______________________________
City: ____________State: ______ Zip Code: _________ FAX:_________________________
Credit Card Order: (__) Visa (__) Master Card (__) Discover (__) AMEX
Name of Card Holder (Please Print): _______________________________________
Account Number: ______________________________ Expiration Date: ______________
Authorized Signature: ______________________________Date: ____________________
CID# _________ (Last 3#’s on back of card for Visa, MasterCard, Discover. Last 4#’s on
front of card for AMEX)
1) Fax Toll Free to (800) 397-3840
2) Send to: Great Western Consulting LLC., 550 East 100 South, Hyde Park, UT. 84318
3) Questions: Call Russ J. Jones at 800-808-6551
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