1^st Family DistributorApplication

Fill in the information requested on this page, then highlight the entire page and copy (Ctrl C) to the clipboard. Then click on the Boss's link above and paste (Ctrl V) to the body of the message.  If you wish to be a 1st Family Access distributor, be sure to print out an extra copy of this page to snail-mail in to the home office.  Be sure to sign in all the appropriate places before mailing that copy.  
Finally, click on my link below, and let me know that you have joined my downline so that I can get to work helping you as quickly as possible.  Welcome aboard.     ---  John W. Nichols

Date:

APPLICANT NAME:

Contact person if applicant is a company:

Address:

City:

State(or Province):

Zip:

Country:

 Phone: ( )

 Fax: ( )

 email:

Social Security Number or Fed Tax ID# (or Fed. Tax ID# )

SSN:

______________________________________________________

SPONSOR:   John W. Nichols     Distributor ID# NIC7134

Sponsor’s E-mail Address:   jnichols@tulsa.oklahoma.net

I AM SUBSCRIBING TO THE FOLLOWING:

_____ Distributor Kit to become an Independent Representative,$25.00

(California residents add 6.5% sales tax)

(A distributor is not required to be a Access Subscriber, nor is the subscriber required to be a distributor. Therefore, you can be both a distributor and a subscriber or either.)

_____ Basic Service Internet Subscriber Unlimited Access, $19.95 per month

USER NAME: __________________ PASSWORD: __________________

_____ EZ SiteMaker Service, $10.00 per month

_____ Autoresponder Service, $15.00 per month. (Includes 3 separate Autoresponders.)

_____ Web Site Hosting, $50/mo (includes 20 MB/s, $250 Setup Fee)

_____ 800# Voice Mail - Flat Rate $29.95/mo + $25 Setup Fee (Optional - Marketing Support.)

This is a great support System for Developing your Downline. People call you on your 800#, but the fee is never more than $39.95/mo. Since this is commisionable at $5/mo through your downline, you will make money on this too while it supports your 1^st Family Distributorship.

Autoresponder service and EZ Site Maker as well as Web Site Hosting is optional and can be purchased separately from 1^st Family.

TOTAL $________________________

INITIAL SETUP FEES: (Select one)

_____ Check enclosed. Make check or money order payable to

Lighthouse Productions, Inc.

_____ Bill to my credit card along with my monthly fees.

Credit card information listed below.

INFORMATION FOR MONTHLY BILLING: (Select one)

______Bill my credit card: VISA____ M/C____ AMEX____

Print Name as it appears on card:

Credit Card Number:

Expiration Date:

Signature:

______You are authorized to debit my U.S. Bank Account. (You will be

sent a separate authorization form.)

Name on Account:

Bank:

Bank Address:

City:

State:

Zip:

Bank Routing Number: (19 Digit Number on bottom of check):

Write "Void" on one check and submit it with your original application.

(Check #____________________)

You may email or fax this form to get started right away, but you will

also need to send the original copy with your signature before any

commissions can be paid to you.

(To Email this form, simply select it with your mouse, Choose Copy from your Browser. Then go to your Email program, start a new message, address it to theboss@1stfamily.com and Paste into the BODY of the message. Fill in the blanks and HIT SEND.)

 Mail original copy to:

Fax (408) 423-8755