SECURE ONLINE REGISTRATION FORM
(Or you can print this form and fax or mail it to us.)

YES,  Please register me as a dealer under your wholesale program. I understand that there are no membership fees or purchase requirements in order to activate my dealership. I further understand that by submitting this form I am authorized to buy direct-mail names at wholesale for my own use or for resale and/or have you drop-ship names directly to my customers. I understand that you are to cover all refund requests in accordance with your stated guarantee policy and that I have free unlimited consultation privileges. 

I hereby agree that I will not copy or duplicate any lists purchased, by any means and that I will use any provided sales materials for the promotion of your lists only. I understand that any other use is strictly prohibited. 

On this basis, please activate my FREE DEALERSHIP immediately upon your receipt of this registration form and send confirmation, dealer instructions and free sales aids to me by return mail. 

Check this box to accept these terms & activate your free dealership. Dated: 

             Your Name: 
	   Address:    
	    City:   State:  Zip: 
   E-Mail Address:
Please scroll down to the bottom of the page to submit this form.
 

We will be happy to answer any questions or concerns you may have at any time; however, we do request that you read over the F.A.Q. (Frequently Asked Questions) before contacting us as many common questions are answered there. If you still have any questions after reading them please feel free to contact us 

e-mail us: mail@pcwlists.com 
 
 
THIS IS A FREE DEALERSHIP - NO PURCHASE IS REQUIRED
 
THE FOLLOWING ARE OPTIONAL ITEMS YOU MAY WISH TO ORDER:

Flat (unfolded) copies of ALL our printable sales material: 3 different full page flyers, postcard, PLUS a professionally written sales letter, PLUS an assortment of Display Ads, all ready for you to add your contact information and get copies made. Just send $2.00 to cover our costs and we'll rush everything to you by return mail. $
PACKAGE #1 - This is the optional package of printable sales material for use with our wholesale program. Each item is professionally typeset with your name (or company name) and address. Included is everything you'll need to look 100% professional: Expertly designed ads, flyers, postcard, sales letter and envelopes, all ready to get copies printed 'as-is'. Full instructions are included. This package is a hassle-free way to put yourself in business instantly! Cost is just $10.00 which is what it costs us to prepare and mail to you. (Important: If you are ordering this package, please enter your name & address, exactly as you want it to appear, in the comment box at the end of this form.) 

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PACKAGE #2 - This package entitles you to participate in our referral program. You will be assigned your own personal code #, we will set up your coded website on our server and you will be entered into our computer files. We will send you the complete collection of ready to print sales material with your new website address and your dealer code in place (includes fax and credit card ordering options for your customers).... under this plan we automatically send you a 50% commission on all orders and re-orders we receive as a result of your referrals. (note: if you wish, you may simply list your website address in your promotions if this is applicable to your situation - full details will be included. Cost for this complete package, including your own web site on our server and lifetime maintenance of your commission account, is just $10.00. This package offers direct-mail leads as well as email leads to your prospects. $
THE MARKETING MANUAL, titled 'How to make $2,000 a week selling names' will teach you everything you need to know to start making big money selling mailing lists! You'll learn who your prospects are, how to find them, how to get them to order and how to keep them coming back for more! - all with a minimum of effort and expense on your part! In addition you'll learn about all the lowest cost sources for printing, advertising and supplies. 
.....this manual was written to teach you exactly how to put money in your pocket without spending a lot. This complete manual covers every aspect of selling mailing lists, from A to Z, and costs just $25.00 - BUT, WE INCLUDE CASH VOUCHERS TOTALING $25.00 which may be used as cash to purchase names from us at wholesale. This way, the manual ends up costing you nothing and you get the knowledge you need for free! 

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**THE WORKS** - Everything we have available, as described above: Package #1, Package #2 (Including your own web site on our server), The Manual plus the $25.00 worth of cash vouchers, plus complete instructions, plus unlimited free consultation - THIS WILL PUT YOU INTO BUSINESS WITH A BANG! - You'll have a complete professional business package that includes all the materials and know-how you'll ever need to make big bucks selling names! This would cost $45.00 if purchased separately, but our special price to you is just $35.00 for the works!

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TO ORDER DIRECT-MAIL NAMES AT WHOLESALE please check ONE choice from EACH of the three sections below and enter your cost in the box below

 Select One:
200 Names - $16
500 - $28
1,000 - $40
2,000 - $68
5,000 - $140
10,000 - $260
20,000 - $440
30,000 - $600

Select One:
Random (nationwide) zip codes
Zip-code sorted (1,000 name minimum order required for zip-sorted names) 

Select One:
Pressure-sensitive (peel-n-stick) labels
Delivered by email (standard comma-separated text file)  

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 *****YOUR SATISFACTION IS GUARANTEED****** TOTAL:   
 $
 
I am paying by: Check Money Order Cash Credit or Debit Card
**U.S. funds only please. Canadian Customers: please add 5% for airmail delivery. Other countries please add 20% for air-mail delivery or 10% for surface mail.

If you use your charge card: 
Card Number  Exp. date 
Security Code  (The security code is the last 3 digits appearing on the back of your card, 4 digits on the front for American Express.)
Name of Cardholder 
Billing Address for charge card 
City  State  Zip

*Important: If you are ordering "Package #1" or "The Works", please use this box to enter your name and address as you want it to be typeset. You may also enter any additional comments if you wish:




OR PRINT THIS FORM AND FAX TO: 954-344-0996
OR MAIL TO:
PAUL C.WILSON, PO BOX 26418, TAMARAC, FL 33320-6418