Application Form
for
Copywriter Protégé Program

Dear Paul,

I'm enclosing my payment for £675 plus £x postage and packing and understand that I will also have to pay for any phone calls I make to you as part of this program.

I also agree that any of the proprietary secrets, techniques, methods, ideas, procedures or materials that I receive will be kept in strict confidence and not revealed in any form to anyone else without your written permission.

Date:_____________ Signature:____________________________________

 

Name (print):____________________________________________________

Address:________________________________________________________

City/State/ZIP:__________________________________________________

Phones (Day/Evening):_____________________________________________

FAX:___________________ Email:___________________________________

 

For VISA/MasterCard/American Express orders only:

Card #:_____________________________ Expiration Date:______________

Signature:_______________________________ Amount: £______________

FAX/Mail the above form with your payment. If you are Mailing the form, leave off your card #/exp date and place an X here:_____ . You will then be called for your card information.

Paul Lock
Incise Communications Ltd
Maple House, Bayshill Road , Cheltenham GL50 3AW
Phone: 0870 420 3181
FAX: 0870 220 1751
paullock@incisecomms.co.uk