I    (FULL NAME) would like to be a Member of the $100 Club Net. I understand that the membership fee is a one time $100. I will also receive my own promotional web page along with my membership certificate. As a new member I will have access to the $100 Club Members Networking Site. I can also receive a $40 signup bonus for every New Member that joins up on my web site. And a $15 signup bonus from my second level Members that sign up under my New Members.

 ADDRESS:

CITY:    STATE:    ZIP:

Phone: EMAIL Address

YOUR SPONSORS NUMBER: 1
YOUR SPONSORS NAME: William B Tomanek