Application for
Copywriter Protege Program



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Application Form

for

Copywriter Protégé Program

Dear Carl,

I am enclosing my payment for $4997 and understand that I will also have to pay for the phone calls I make to you as part of this program.

I further understand that you may be making audio tape recordings of some or all of our sessions on the phone and I do hereby give you permission to do so and agree that you will have full ownership of these tapes to do with as you please.

I also agree that any of the proprietary secrets, techniques, methods, ideas, procedures or materials that I receive will be kept in strict confidence and not revealed in any form to anyone else without your written permission.

Date:_____________ Signature:___________________________________________

 

Name (print):_____________________________________________________

Address:________________________________________________________

City/State/ZIP:____________________________________________________

Phones (Day/Evening):______________________________________________

FAX:__________________ Email:____________________________________

 

For VISA/MasterCard/American Express orders only:

Card #:______________________________________ Expiration Date:_______

Signature:___________________________________ Amount: $_____________

FAX/Mail or Email the above form with your payment. If you are Emailing the form, leave off your card #/exp date and place an X here:_____ . You will then be called for your card information.

Carl Galletti
PO Box 3934
Sedona, AZ 86340
Phone: (928) 649-2407;
FAX: (928) 649-2409
[email protected]
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Copyright © 2002 by: Carl Galletti