Subscription Application Form

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Secure Subscription Form

We respect your privacy. The personal information requested below is for use in processing your credit card, which is done with secure encryption. We never reveal, share, or sell member information. For complete details see our Privacy Statement. We accept the credit cards shown below as well as PayPal. Paying by PayPal charges you immediately, however there is no 21 day trial or monthly payment option, only an annual payment. If you prefer to pay via PayPal, you may subscribe here. If you wish to pay by credit card, fill out the form below:

"I've succeeded in doubling my traffic without spending a dime. My organic and direct hits now exceed the traffic I receive through pay per click ads." Trish Barker- ConnectionsPuzzles.com

Customer Information

* = Required - Must match credit card billing address!

First Name [ required ]
Last Name [ required ]
Company
Address Line 1[ required ]
Address Line 2
City [ required ]
State [ US & Canada ]
State/Province [ All other Countries ]
Zip/Postal Code [ required ]
Country [ required ]
Your E-mail Address [ required ]
Phone or Fax Number [ required ]

Shipping Information

Shipping same as billing address

Ship To First Name [ required ]
Ship To Last Name [ required ]
Ship to Company
Ship to Address Line 1[ required ]
Ship to Address Line 2
Ship to City [ required ]
Ship to State [ US & Canada ]
Ship to State/Province [ All other Countries ]
Zip/Postal Code [ required ]
Ship to Country [ required ]

Subscription Options

Subscription Plan: Online Payment Processing	We remove any of the risk by offering you a 21 day trial for only $1! You get full access to the entire site for 21 days. If you cancel before, you won't be billed any further. Join now and get the most from your website. . Monthly- $1 trial for 21 days! After the trial period, your credit card will be charged $19.97 automatically each month. Cancel at any time. Annual- $1 trial for 21 days! After the trial period, your credit card will be charged $187.00 automatically each year. You save $52.64 over the monthly plan, that's almost 3 months for free! Cancel at any time. ~~$97 registration fee plus $24.97 each month. Not in effect yet.~~ Sign up now to lock in the current low rate. Note: trial offer valid for new members only.

Choose LOGIN Name [ required ]

Choose PASSWORD [ required ]at least six characters long, using alphas and numbers, no spaces.

Confirm PASSWORD [ required ]

Payment Information

Payment Method [ required ]
Credit Card Number [ required ]
Credit Card Security Code [ required on (MC/Visa/AMEX) ? ]
Expiration Date [ required ]	/
Name on Credit Card [ required ]
Is this a Renewal?
Do you wish to receive email alerts?
<<< Please Check The Box to acknowledge that you have read and understood our terms of use.


NOTE: It can take up to a minute to process the credit card information and obtain approval. Please do not press the submit button multiple times - doing so could cause double billing.
For the protection and privacy of our visitors and customers, as well as the security of the server, suspicious activities on our site are monitored, tracked and reported.