EmailMe Form - Talk Fusion

Name *

First Last

This is the name that you want on your Talk Fusion Account

Date Time

MM / DD / YYYY

Phone *

### - ### - ####

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

This address must be the same address that is on the card that you will be using to pay for your package

Email *

Confirm

Provide FIRST AND LAST NAME of the persona who referred you *

If you do not put both the first and last name of your enroller in the box, your timestamp app will not get processed

PRODUCT PACKAGES

Refund and Cancellation Policy: If any User is unsatisfied with their initial purchase of Products and Services, Talk Fusion offers a 100% three (3) day refund period (72 hours) from the date of purchase

Select the package that you want to start with *

Start Package $175 USD (Onetime) $20/mo

Elite Package $350 USD (Onetime) $40/mo

Pro Package $700 USD (Onetime) $50/mo

CREDIT CARD INFORMATION

CARD WILL NOT BE PROCESSED UNTIL WE GO LIVE. Member must have card on file to get placed in the team according to timestamp agreement. We will email you 1 to 3 days before we process your card.

Name on the Card *

First Last

Last 4 digits on the card

We will be calling you to get your credit card number

Price

$ Dollars . Cents

This is the amount that my card will be charged on the day Talk Fusion goes live. The initial amount charged is just the package

Acknowledgement *

I acknowledge that

if my card does not process, I only earn the Fast Start on my personally sponsored people. All team build commissions are forfeited until such time that I activate my position by updating my credit card info and resubmitting the purchase from my back office after we go live

Agreement *

By checking this box and signing this Application, you are indicating that you have read, understand and agree with the Talk Fusion Policies & Procedures and Terms of Service

Signature of Card Holder and Applicant *

Clear

by signing this Application, you are indicating that you have read, understand and agree with the terms of this form and the Talk Fusion Policies & Procedures and Terms of Service