SignOn... Please print and fill out this form, which should be included with the writing sample:

Last name________________________ First name________________________

Address (street, city, state, zip)___________________________________________________

Phone with area code (optional) ___________________ . . .Email Address_________________________

Name of person who has written the sample (if different from above):_________________________________________

____ Male ____Female . . . . . AGE (____10-20) (____21-40) (____41-60) (____61+)

Occupation (if applicable)___________________________________________

Service(s) Requested

INDIVIDUAL ANALYSIS:

____ 1/2 hr. tape ($50.00)

____ 1 hr. tape ($75.00)

____ Graph: ($10.00)

COMPATIBILITY REPORT:

____ 1/2 hr. tape ($70.00)

____ 1 hr. tape ($90.00)

____ Each Graph: ($10.00)

BUSINESS ANALYSIS

____ Profile and 1/2hr tape $ 90.00

____ Profile and 1 hr tape $150.00

COMPATIBILITY BUSINESS ANALYSIS

____ 2 Profiles and 1/2 hr tape $160.00

____ 2 Profiles and 1 hr tape $275.00

STUDENT PERSONALITY & LEARNING STYLE: (age 10 and up)

____ 1/2 hr. tape $40.00

____ 1 hr. tape $60.00

____ Graph: $10.00

Indicate Total amount enclosed (prices include shipping and handling) ___________

OTHER

Analysis tailored to your needs: An audio taped analysis can be conducted by conference phone. Phone analysis will be scheduled at your convenience. The audio tape will be sent following the phone session. Call or email to discuss details of your special request and pricing.

If you are submitting someone else's sample with yours for compatibility, be it as a couple, friends, family, or co-worker, we prefer that the individual sign below:

I give permission to SignOn to analyze my handwriting _______________________________________

BE SURE TO INCLUDE THIS FORM, HANDWRITING SAMPLE(S) AND MONEY ORDER OR CHECK MADE PAYABLE TO SignOn

Payment must be received prior to obtaining your analysis.