Dear New Customer, please use print writing or
type directly in the requested fields.
Please complete and print this document, then attach it to your Money
Order or
Certified Check and send it by registered mail to your Coastal
Director.
Please ship my package to:
Name of Independent Coastal Director: Your
Name
(optional)
YOUR COMPANY NAME
Direct Phone #: Your
Office or Cell #
Toll-free Phone #: Your Toll-Free #
Address:
Your Address
City: Your City / Town
ZIP / Postal Code: Your Postal / ZIP Code
State / Province: Your State or
Province Country:
Your Country
Date: _____/_____/______
First Name:
Address:
City:
State/Province:
ZIP/PostalCode:
Phone:
PACKAGE
PRICE
QUANTITY
TOTAL
Level 1 - The Coastal Resort Vacation Package
Membership Cards, Deep Discounts on Condo rentals,
RV Hookups, Recreation,
Hotel Stays, Restaurants, Golf, Cruises,
Car Rentals, Theme Parks, Hundreds of
Vacations and Cruises,
etc. Receive over $15,000 worth of Vacation & Travel benefits!
$1,295 x
Premier Package - Combination of Level 1
and Level 2
Includes Membership to Hundreds of Vacations around
to World, Unlimited Cruises
and much more... (incl. Free Ticket
To Coastal Training Seminar)
Save $800
$3,995 x
Platinum Package - Combination of Level 1,
Level 2 & Level 3 Travel the Planet with Level 3, Lifetime
Membership, Thousands of Vacations,
Hundreds of 5, 6 and 7
Day Cruises, Many All Exclusive Vacations, plus much more
(incl. Free Ticket To Coastal Training Seminar)
Save $1,295
$11,000 x
COMMENTS:
SUB-TOTAL:
FREIGHT: (Fed Ex Only: USA:$25 International: $75)