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	Item	Unit Price	Quantity	Subtotal
	Regular Plan-A (3 Days Per Week)	$45.00		$45.00
Current Total (USD): $45.00

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Full Name *

Please enter the full name of the person or company as it appears on your credit/debit card or PayPal account. (Example: John A. Doe)

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Address 1 *

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Address 2

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Phone

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Please enter your phone number. (Example: 614-620-6266)

Phone Extension

Optional: Enter your phone extension.

Please include only numbers and optional spaces and dashes for your extension. Extension can only be 16 digits long.

Email Address *

We use your email address to send you an order receipt and to contact you if there is a problem with your order. We will never send you unsolicited emails.

Your email address is required. Please enter your email address. (Example: john.doe@example.com)

Upon completion of your purchase, a receipt will be sent to this e-mail address.

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You will be redirected to PayPal to make your payment. After completing your payment, you will be forwarded back to our website to view or print your receipt.

By completing my purchase, I confirm that I am over 16 years of age and I agree to the Payment Terms, Terms of Use, and the Privacy Statement.

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