I read Letter of Intent and agree on its content.
First Name:

Surname:

Address:

City:

County:

Postal Code:

Country:

9-Digit ID#(Tax/Passport/SSN):

Phone:

Fax:

Email Address:

User name:

I would like to receive my Checks: By Mail   E-Gold   Paypal
If E-Gold account number and name:

If PayPal Name and email address:


If you want a PayPal account Click Here. (highly recommend).
Make payments with PayPal - it's fast, free and secure!

I will benifactor you into Tri-Miracle and then will notify you what to do next,
but in the meantime, start lining up your 3 people.