Hobbies: *
Personal Reference #1: *
Phone #: *
(example 999 999-9999)
Personal Reference
#2:
Phone #: (example 999 999-9999)
Personal Reference #3:
Phone #: (example 999 999-9999)
Bank Wire Transfer
Information (so we can wire
funds directly into your bank acct.)
Bank Name:
Type of Account:
Checking
Savings
The following #'s can be found on your business checks, to
see where Click Here
ABA Routing #:
Bank Account
#:
Address 1:
Address 2:
City:
State:
Zip:
ACH Phone #: (example 999 999-9999)
Profit-Alliance Site Business Information
Desired
Site Name: * Profit-Alliance
Experience in This Line of Business: *
My 1st Month Goal: *
100 members x $10 (40% of $25) = $1,000 / month
150 members x $10 (40% of $25) = $1,500 / month
200 members x $10 (40% of $25) = $2,000 / month
250 members x $10 (40% of $25) = $2,500 / month
500 members x $10 (40% of $25) = $5,000 / month
750 members x $10 (40% of $25) = $7,500 / month
1,000 members x $10 (40% of $25) = $10,000 / month
2,500 members x $10 (40% of $25) = $25,000 / month
5,000 members x $10 (40% of $25) = $50,000 / month
10,000 members x $10 (40% of $25) = $100,000 / month 20,000 members x $10 (40% of
$25) = $200,000 / month I'm going to celebrate by...
My 6 Month Goal: *
200 members x $10 (40% of $25) = $2,000 / month
250 members x $10 (40% of $25) = $2,500 / month
500 members x $10 (40% of $25) = $5,000 / month
750 members x $10 (40% of $25) = $7,500 / month
1,000 members x $10 (40% of $25) = $10,000 / month
2,500 members x $10 (40% of $25) = $25,000 / month
5,000 members x $10 (40% of $25) = $50,000 / month
10,000 members x $10 (40% of $25) = $100,000 / month 20,000 members x $10 (40% of
$25) = $200,000 / month I'm going to celebrate by...
My 1st Year Goal: *
500 members x $10 (40% of $25) = $5,000 / month
750 members x $10 (40% of $25) = $7,500 / month
1,000 members x $10 (40% of $25) = $10,000 / month
2,500 members x $10 (40% of $25) = $25,000 / month
5,000 members x $10 (40% of $25) = $50,000 / month
10,000 members x $10 (40% of $25) = $100,000 / month 20,000 members x $10 (40% of
$25) = $200,000 / month I'm going to celebrate by...
My Dream Vacation is: *
Choose Your Host
username: * (example: myname123 ...
can be 4 to 15 characters, any combination of letters and or numbers only)
keep it simple
Choose Your Host
Password: * (example: mypass123 ...
can be 4 to 15 characters, any combination of letters and or numbers only)
keep it simple
Host Agreement: * To view
agreement Click
here
I am stating that I have read and agree to, the terms outlined in the Profit-Alliance.com
Agreement (see link to the left to view), by selecting
this box
YES
NO
Host Start-up Fee:
The Host start-up fee of
$ 995 is a one time ONLY fee which covers part of the site set-up and site training.
Upon approval of your application you will receive a PayPal email
"request for payment" for the above non-refundable amount.
Please note this fee is scheduled to increase to $2,500 on
6/01/2009
If
your application is accepted: Upon
approval of your application you will receive a PayPal email "request for
payment" for the above non-refundable amount of $ 995.00 USD.
Please
remember, there will only be one Site Host per industry...
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Profit-Alliance Corporation
All Rights Reserved
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