Order Form for Fall Special Only
Speakers, Trainers and Consultants

Special Fall sign-up rates and new billing/cancellation option
Bring a friend and you both save 50%!
This offer is limited to the first 20 orders placed -
don't delay, start promoting your business more....do it today!

EXPERT Magazine
Better People...Better Business 

6191 NE 64 St, Silver Springs, FL 34488
Phone 352-438-0261  Fax 352-438-0262    Email [email protected]

Contact Information

Name    
Company
Address 
City        
State       Zip Code
Phone
Fax    
E-mail

Your Sign-up partner's name
Your sign-up partner's email 

Your Order

Listing in our database of Professional 
          Speakers, Trainers and Consultants

                   $149 per year; see Rates & Specs
       Your primary topic 

Amount


            $

Additional topics/listings                      
         $25 each per year; see Rates & Specs; 
                  Add'l Topics
                                  
                                  
I will let you know my topics later. (Please
indicate the quantity of additional topics)
___ X $25  $

Total Order - Annual Rate Paid In Advance

                 $

We've added a new payment option!

Yes, bill the total order outlined above in  one payment in advance - I save the $29 set up fee for extended billing accounts.

OR

Yes, I would like to take advantage of your extended billing option.  There will be a one-time set up fee of $29 plus $12.50 per month for the first listing and $2 for each additional listing,  
and I can cancel at any time.

Payment Information

VISA  MC AMEX Check/Money Order
Total Amount of This Order      $
Card Number    
Name on Card  
Expiration Date
Billing address of card if different from above (include zip)

Your Signature
___________________________________________________________

This is not a secure ordering system.  You may submit this form by using the submit button below,  or you can print this form and fax completed form to us.  Once your order has been processed you will be assigned passwords via email to enter/edit your listing 24/7.  If you prefer us to  enter your listing(s) for you, we would be happy to do so.  At this time your passwords will not allow you to post the photo, we will have to do that.

Thank you for the order.  We look forward to working with you!

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