Avax Consulting, Inc.

Home Internet Consultants Jump Start Kit order form

By François Muscat and Vishay Singh

 

ORDER FORM FOR JUMP START KIT :

 

Please fill in the details below in order for us to set up and get going:

 

Please provide a photo of yourself. A pass port size that is clear with light clothing colors will be sufficient.

 

Name

 

Surname

 

Email

 

Skype

 

Twitter details

 

Face book details

 

Linked-in details

 

Business name

 

Business address

 

Billing address

 

Office Phone

 

Mobile Phone

 

Fax

 

Official business website

 

Blog details and access details

 

No. of years as an IC:

 

Geo targeted Areas please be sure of the areas tip try 100mile radius

 

Current service offerings

 

What product or service do you sell most

 

What product or service do you have the most enquires on

 

Payment methodology ( please tick for now accounts will contact you )

Credit card
Bank transfer
Check
Online payment

 

Comments

 

I accept that I will be charged $500 per month for the services as detailed in the Power point documents I understand that this is a 12 month process; and that I can cancel by giving 30days notice in writing to Vishay Singh of Avax Consulting Inc situated at 3113 Roswell Road Marietta GA 30062.I understand that this program makes no guarantees to me ; and that it is a methodology that will create an online marketing strategy for myself as a wsi consultant. I confirm that I have read and understood the no surprises policy as and agree to same.

 

Client :

 

Date :

 

Designation :

 

Please email back to us at Vishay@avaxusa.com, Lydia@avaxusa.com, or info@avaxusa.com

 

Contact us on :

 

 

Francois Muscat • Internet Marketing Consultant
T: +27.11.468.3138 • C: +27.82.809.5655 • www.wsioms.co.za • E: Francois@wsioms.co.za