Which geographical location(s) are you most interested in? Please
provide details of country, city, state and population.
Are you interested in obtaining an exclusive license in this location(s)?
When would you be able to begin?
Will anyone else be assisting you (partner, investor, consultant, etc.?)
Please fill in names, addresses and contact information below.
Name:
Address:
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State:
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Country:
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Fax:
Home Telephone:
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Name:
Address:
City:
State:
Zip Code:
Country:
Business Telephone:
Fax:
Home Telephone:
Email:
Name:
Address:
City:
State:
Zip Code:
Country:
Business Telephone:
Fax:
Home Telephone:
Email:
Why does your company wish to become an Optimal Associate?
How will you finance your start-up?
I declare the information above is correct to the very best of my knowledge.
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Date:
PRINT this page and mail it to The World Academy of
Personal Development Inc., P. O. Box 12045, Marina Del Rey,
California 90295, U.S.A. or fax us at (310) 362-8845. A representative
will contact you within three business days.
