EmailMe Form - *College Consultants or Affiliates Agreement

Consultant or Affiliate Name *

First Last

Preferred Email *

Cell Phone *

### - ### - ####

Address *

Street Address City State / Province / Region Postal / Zip Code

Consultants refer and enroll one candidate from your current contacts then you select a single zip code as the center of your selected marketing area. We expand 360 degrees from zip code to secure 1,000 candidates which meet minimum selected household income.

Selected Zip Code

$150,000 Household income or greater

Billing reads MARKET CONSULTANTS

We accept most any method of payment.
CHECKING or SAVINGS ACCOUNT preferred.

Date *

MM / DD / YYYY

Choose One Please *

Consultant - We prospect for you monthly upon request. $100 per month.

Affiliate - You provide the prospects. $100 only.

Signature ~ Email may be used *

Submitted on a secure server and a copy of the agreement will be emailed to you for your records. Submission verifies your IP address.