Print & Mail / Fax Registration Form for

The Science of Getting Rich for Practical Geniuses™
Online Course & Private Web Site

Print ... fill out ... and mail or fax this form with your payment.
For secure online ordering with major credit/debit card or PayPal, please visit

STEP 1: Print out this form and fill in all the information requested ...

__Sign me up! I'm saying YES to the opportunity to enhance my learning experience, multiply my results, AND set my own tuition for The Science of Getting Rich for Practical Geniuses™" Online Course & Private Web Site.

After careful consideration, the amount I've determined is right for me is

  • $__________ (one-time payment), OR

  • $__________ per month (until I cancel payments).

Please note: At this time, monthly payments can be set up only with a credit or debit/check card (or through your online PayPal account). For credit/debit payments, an initial payment will be charged when we receive this registration, and then automatically at 30-day intervals until you cancel. Ending your payments does NOT end your access to the course and private site, and you may cancel your payments at any time.

Please PRINT clearly!
Email address is required for our records and to send your course access information.

STEP 2: Payment Information(Payment must be in US funds)

(Cardholder) Name:


(Billing) Address:  

City & State/Province:


Zip/Postal Code:


Credit Card Account No.:


(Cardholder) Signature:

Thanks — and congratulations!

__Check (US$) __Money Order (US$) __VISA __MasterCard

STEP 3: Mail or FAX this form with payment to ...

Certain Way Productions
P.O. Box 140279
Dallas, TX 75214 USA
FAX TO: 314-480-9229

STEP 4: Watch your email for your registration confirmation and course access codes! For speediest access, please register ONLINE at:

©2002-2011 Certain Way Productions Inc.