FORMS

ORGANIZE

"ONCE YOU HAVE CLEAR IDEA OF YOUR PRIORITIES, THAT IS YOUR VALUES, GOALS AND HIGH LEVERAGE ACTIVITIES, ORGANIZE   AROUND THEM." - Stephen Covey

DIRECTIONS:

1. Congratulations on your enrollment, you're awesome!

2.  * indicates required and "On File" is not accepted.)

3.  Submit before deadline (forms are not accepted even 1 minute past deadline).

3.  Submit this Enrollment Form & the Ad Design Form immediately for quickest proof.

4.  TOP PRODUCER'S TIP: Complete as much of this form as possible BEFORE your presentation.

ENROLLMENT FORM
ORDER
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CUSTOMER
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PAYMENT & TERMS
All invoices will be issued on or near the 1st of each month, yet if a payment date falls on a weekend we will charge the prior business day.  The inside coup® will e-mail invoices to the e-mail address provided at the top of this Enrollment Form and Agreement.  I authorize my financial institution to pay and charge by electronic funds transfer and I accept all credits and debits to my account as a result of services provided by the inside coup® described in this Enrollment Form and Agreement. All invoice amounts 30 days past due will incur a $50 late fee per month.  The authorization shall remain in effect for the length of this Enrollment Form and Agreement. All Credit Card Processing in Ohio will incur a 3% fee.
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Automatic bank draft is also accepted, if this is preferred please enter:
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Send a Call Tracking Report 2x a month?
INITIAL PAYMENT
Process payment in full?
UPLOAD LOGO & IMAGE(S)
Upload 300 DPI Logo
15MB maximum
Upload Customer Supplied Artwork
15MB maximum

ad inquiry

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franchise inquiry

 1 (602) 595-6550

5111 N. Scottsdale Rd. Suite 260 

Scottsdale AZ, 85250

© 2019 the inside coup®

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