Products Price Quantity Total

Products		Price	Quantity	Total
2015 - PW Setup / Activation Fee	$499.00	Update	$499.00
2015 - Diamond License / Membership 1st Location 30 days free, then $399.00 / month	$399.00 $0.00	Update	$0.00
Subtotal			$499.00

2015 - PW Setup / Activation Fee

$499.00

Update

$499.00

2015 - Diamond License / Membership 1st Location

30 days free, then $399.00 / month

$399.00

$0.00

Update

$0.00

Subtotal $499.00

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Order Summary

Subtotal $499.00

Order total $499.00

Order Summary
Subtotal	$499.00
Order total	$499.00
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I authorize Powerful Words Character Development, LLC to charge me for the above total. I further affirm that the name and personal information provided on this form are true and correct.

I understand and agree that I've joined the Powerful Words Character Development Program's Diamond Level (1 Location) Monthly Membership and that I will be be charged a monthly subscription/membership rate of only $399 - each and every month that I am a member.

I further declare that I have read, understand and accept Powerful Words Character Development, LLC's business terms as published on the PowerfulWords.com web site.

I understand that I may cancel my Powerful Words License/Subscription at any time, for any reason WITH A 30 DAY WRITTEN NOTICE - by fax or certified mail to Powerful Words P.O. Box 283, Mt. Freedom, NJ 07970.

I also understand and agree that should I cancel my Powerful Words License/Subscription at any time, for any reason, I am no longer legally permitted to use the Powerful Words curriculum, logo, character materials/projects and or any reference to Dr. Robyn Silverman, her credentials or her celebrity.

I understand that should I choose to cancel my Powerful Words License/Subscription, I might NOT be permitted to re-join at a later date.