Coastal Vacations Purchase Order Form
New Customer (Please Print or Type) 
        

Ship to:  

Independent Director:

_____________________________

PO#: ________________

Date: ________________
Name:

Address:

City:

State:

ZIP:
Phone:
   
PACKAGE

PRICE

QUANTITY

TOTAL

Level 1: The Coastal Vacation Package

$1,295 x

Level 2:  Three Day Seminar on Finance, Motivation, Travel, etc.

$3,500 x

Premier Package: Combination of L1 and L2 together.  (Save $800!)

$3,995 x

Level 3: Week-long Vacation/Seminar Event

$7,000 x

Platinum Package: Combination of L1, L2 and L3 together.  (Save $1,545!)

 $10,250 x

TERMS and INSTRUCTIONS:

Complete, print then mail or fax this pre-application form to your Coastal Director and he will contact you for payment arrangements. 

Contact Information Here

 

 

SUB-TOTAL:

FREIGHT:
(UPS $10
FED EX 2nd day air $25)

BALANCE DUE:

DIRECTORS RELEASE: As per our agreement with the independent business people of COASTAL VACATIONS, you must be a certified director to purchase products directly from us.  (Sorry no exceptions)

PLEASE CONTACT US IF YOU NEED ASSISTANCE.  THANK YOU.