YES! I would like to participate in the Maximum Exposure Co-op immediately. I understand that I will receive my own personalized access code to the co-op's 800 voice mail, notification of where and when the ads will be running and step-by-step instructions on how to retrieve my messages. I would also like to receive a free checking copy of each of the publications in which our co-op ads appear.
First Name   
Last Name
Street Address
City
State
Zip
Country
Phone  
URL
E-mail
System Username or ID
 
(if applicable)
 
Network Marketing Company
Price per share for this Coop
 
How Many Shares      Your Total   $

Would you like to also join the Auto-Renewal Program and receive an extra 20 FREE Leads each month from our in-house stash?

 Yes! Of course I want 20 FREE Leads each month! Please automatically renew this order each month and charge my credit card listed below for the cost. I may cancel this Auto-Renewal in writing at any time 15 days prior to the co-op closing date. Auto-Renewal is only available to those paying by credit card.

By checking this box you are agreeing to have your credit card charged every time the coop is running as long as you are a part of the co-op. Cancellations must be in writing (sent by fax, e-mail or regular mail) and received in our office 15 days before the co-op closing date. If you are unsure of your co-op closing date please call 1-800-561-9297x123. Please include your name, address, phone # and date, along with the product or service you wish to cancel

 No. Not at this time.
 

Payment Information

Select payment method:
Card Number
Expiration Date Month     Year  
Card holder's full name
Card holder's address
Card holder's phone number