Application Form

Send Cash, Check or Money Order to:

Worldwide Marketing
P.O. Box 794
Norco, CA 92860-0794 USA

ORDERS PAID BY PERSONAL CHECK WILL BE HELD 20 DAYS FOR BANK CLEARANCE.
ENCLOSE $10.00 FOR THE COMPLETE HOMEMAILER'S PROGRAM.

______ Also enclosed is $2.00 extra to RUSH my order via First Class Mail or for orders outside of the USA. (Please print neatly)

HOW DID YOU FIND OUR SITE?_____________________________________

NAME______________________________________________________________

ADDDRESS__________________________________________________________

CITY____________________________STATE____________ZIP________________

TELEPHONE:(_____)___________________FAX:(_____)_____________________

E-MAIL ADDRESS_____________________________@____________________________

SIGNATURE____________________________________________DATE____________

The amount of money I want to earn each week is _____$100 _____$500+