PLEASE FILL OUT EVERYTHING ON THIS FORM BELOW ACCURATELY & CORRECTLY.  

FAILURE TO DO SO WILL RESULT IN MEMBERSHIP DISQUALIFICATION.  WE DON'T ASK FOR A LOT OF INFORMATION, WE JUST NEED ENOUGH TO MAKE SURE YOU ARE LEGITIMATE & ACTUALLY A SERIOUS POTENTIAL NEW CUSTOMER.   IT ONLY TAKES A MINUTE TO FILL OUT.  

ALL OF OUR CURRENT CLIENT'S ARE HAPPY THEY DID, AS WE PROVIDE A QUALITY SERVICE TO ALL OF THEM!!!  THANKS AND WE LOOK FORWARD TO HAVING YOU IN THE CLUB!!!!!