Items Schedule The Items Schedule forms part of and is to be read in conjunction with the Service Agreement (Terms & Conditions)Item 1 Full legal name of the business owner(s) and/or trustee(s)Business Type*Sole TraderPartnershipCorporationTrustFull Legal Name of Business*Registration Number*Trading Name (if applicable)Business Address* Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Telephone (including country and area codes)*Item 2 Nominated ContactFull Name*Email* Mobile/Cellphone (including country and area codes)*Item 3 The Work to be performed Work pursuant to the Mentoring Service Package selected by the Client together with all other services deemed necessary by the Company to adequately perform the work.Item 4 The Fees The Monthly Fees for the Minimum Term pursuant to Paragraph 4.3 of the Service Agreement (Terms & Conditions).Service Packages*Please select the Service Package you requireCLICK HERE to compare Service PackagesStrategic Mentor Service Package - $999 USD MonthlyTactical Mentor Service Package - $1,999 USD MonthlyMarketing Mentor Service Package - $3,999 USD MonthlyDeclaration I/We the person(s) named in Item 1 confirm that the information provided by me/us to the Company is accurate and complete and hereby acknowledge having read the Service Agreement (Terms & Conditions) which together with this Items Schedule forms the entire basis of the agreement between me/us and the Company.Total Payable Monthly $0.00 Please enter your credit card details*Your credit card payment will be processed securely, via Stripe. MasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Security Code Cardholder Name Signature*PhoneThis field is for validation purposes and should be left unchanged.
