Order Now
 OFF- LINE ORDER FORM FOR SUBMITTING CHECKS
Package #1 is $149, Package #2 is $469 (see pricing info for #2)
Please print the order form below. Fill out the information completely. Postal mail the following items:
1) Order Form 2) Business Checks only for Package #1 or #2
Make check payable to: Geraci & Associates. Mail to: Geraci & Associates,
333 Orange Dr., NW, Port Charlotte, FL 33952 NOTE: Please allow 5-business days
for your Biz eProfile to be emailed to you as checks must clear banks.
< PLEASE PRINT CLEARLY >
Date: _________________
Name of Person Ordering: __________________________________
Web Address: WWW. ___________________________________
Email Address: _____________________________________________
Office/Home Land Line: ( ) _______________________
Cell: ( ) ______________________
AUTHORIZATION - PLEASE PRINT CLEARLY
I _______________________________________________ authorize Geraci & Associates to gather the necessary information from the web address listed above for the sole purpose of creating a Biz eProfile. All the information that is contained in the above website is correct and up-to-date.
X_______________________________________________
Authorized Signature of Person Ordering
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