ResponseLinx (tm) Reader Service #0003-1

Welcome to the ResponseLinx (tm) Reader Service. You were directed here from an Internet advertisement as a way to give you instant information about the product or service you were interested in.

In order to receive the information at your e-mail address within a few minutes, please fill in the information below, click the ResponseLinx (tm) button and then check your e-mail for written information.

Please Note: You must at least fill in your correct e-mail address and name in order to receive the requested information. It must be in the format of yourname@aol.com with no spaces.

Other information is directly available from the advertisers website located at: http://www.responselinx.com

Please provide the following contact information:

Name

Title

Organization

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

Home Phone

FAX

E-mail

Optional, do you have any interests in the following areas? (check appropriate boxes):

MLM/Business Opportunities
Health & Nutrition
Computers & Internet
Internet Marketing
Real Estate
Investments
Sports

Other Interests:

Name
Title
Organization
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Home Phone
FAX
E-mail

ResponseLinx (tm) Reader Service #0003-1

ResponseLinx (tm) is a trademark of Orbis Business Services. Last revised: October 20, 1999

ResponseLinx (tm) is a trademark of Orbis Business Services.
Last revised: October 20, 1999