Please, fill out this form and paste in the e-mail.
Sponsor Informations:
Fist name                         Last name
Daniel                            Leblond
Identification code:    E

New member informations: (write where is the star *)
Fist name                            Last name
*                                            *
Birth date:    Day   *     Month    *     Year    *
Address:    *
P.O.Box:
Place:    *
City:    *
Zip code:    *
Country:    *
Phone:    *                                         Fax:    *
E-mail ( Internet ):    *
Occupation:    *                                                     Responsability:    *
Gender ( F=femal, M=masculine, A=association/foundation, C=company ):    *

Group:         Price         Members for qualificaton
    E                $1,000                             3

Example money back  E group
Level         Group     Price subscription    Members     qualifying     Free income
    0                E                $1,000                             you                  3                   $0
    1                E                $1,000                             3                                           $1,000
    2                E                $1,000                             9                                           $1,500
    3                E                $1,000                             27                                        $2,250

If you are ready to integrate, with any happy other members, Cyber Community Partner department of Soft integer USA corp. and agree the general conditions without reserve, sign this solicitud form.

Welcome to Cyber Community Partner department.

I assert to read all the rules document and accept the conditions or rules of Cyber Community Partner.