Merchant Account Holders Form
Name
Email
Phone
w/area
code
Name of
Company
OR
Associate/Employee
Owner
Business Address
(inc. zip)
Billing Address
(inc. zip)
Discover
Paypal
Master Card
Payment Method
Visa
Card Number
Exp. Date
OR
Paypal Email
Your account will be billed if and only when we receive a gift
certificate application with your name, business, and certificate
number  included in the application.  Please keep your
certificates in a private place and keep a record of who you
gave the certificates to for security reasons.  

Each company  will be charged $40.00 for each client which
equals a 20% discount from our regular memberships.  Also at
the time we receive your first client gift certificate information,
we will award you, a family member or friend a free one-year
membership.  For individuals within a company, you will receive
a free membership when you have 5 people signed up.
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