250 Payday Branded Page Order Form

Click the button to pay $69 for
your branded sales funnel

Fill out the form below then submit

Dan's Branded Capture/Sales Page Order Form
Questions marked by * are required.
1. Name:
2. Last Name:
3. Email Address:
4. 800Link Number:
5. Personal Phone Number:
6. Your 250 Payday URL (from Josh) *
7. Your Sponsors Name *
8. PayPal Email Address:
9. Authorize.net Payment Button Link: (Optional)
10. Aweber User Name:
11. Aweber Password:
12. Aweber Form Raw HTML Code: (Optional)
13. Upload Profile Photo Here:


If you submit this form to me anytime before 3:00pm you will receive your pages the same day. After 3:00pm it will be the next day.

If you are an experienced marketer and do not want me in your Autoresponder account, please submit an html form code with name & email address for fields. (#10 on form)


Don't Forget To Click Submit