#2 -  Order Certified Membership (Complete form below and submit)

Certified Lifetime Membership - $89 
(Includes Certified Workaholic (CW) Designation 
PLUS  Deluxe Survival Kit).

See what you will get with membership

PERSONAL INFORMATION:
First name
Last name
Company
Street address
Address (cont.)
City
State
Zip Code
Country: U. S. or Foreign (enter name)
Comments or explanation of order
E-mail

PAYMENT INFORMATION

Membership Cost:  $89

Add Postage & Handling: Survival Kit within U. S. = $7  Survival Kit Outside U. S. = $11 (4-6 weeks delivery exc. Canada)   Survival Kit Airmail Outside U. S. = ? (4-7 days delivery)   Foreign airmail 4-7 days available at our postal cost (Examples: Australia $28.76, Latvia & Russia $21.60)  E-mail hq@workaholic.org for YOUR cost.

Sales Tax 6% (if you live in Nevada)

Total Cost (Insert Amount):    Payment By:Charge Check to follow Charge with PayPal*

Card Number: Expires: *See below for secure credit card charges via PayPal -  don't enter card info. here if you are using PayPal. It's free and easy.

ALL FUNDS IN U. S. $$ ONLY Don't forget your Charge Card Number if paying by charge! To fax credit card order send to 702-838-8853.  OR call in your order to 702-838-6056 or 888-888-8020.

Refund Policy: Refunds granted within 30 days of the charge.   Statement will show charge to E. H. Manley and Associates. To submit your order please click on Submit Form