PLEASE SELECT A SUPPORT PLAN, then MAIL THIS FORM ALONG WITH YOUR CHECK OR MONEY ORDER. SORRY, IF YOU WISH TO PAY WITH CREDIT CARD, PLEASE CLICK YOUR BROWSERS BACK BUTTON AND CLICK ON THE GOOGLE CHECK OUT BUTTON FOR THE CONSULTING OPTION YOU WISH.

(Please PRINT clearly)

Your Name:___________________________________

Address: _____________________________________

Phone Number: ( ___ ) ___________________________

eMail: ________________________________________________

BRIEF DESCRIPTION OF INFORMATION YOU SEEK :

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Fee's are currently 25% off my normal consulting rate!

(Discount is for new clients only)

______ Telephone consultation and advice $295.00 $195.00

This option puts you in a direct one-on-one 45 minute phone conference with Jay.  We will talk about your career objectives and cover multiple questions and topics of your choice.

______ 3 Month E-Mail Consultation & Support $700.00 $495.00

This option has you in an on-going dialogue conference with me for up to 3 months ! We will exchange e-mails covering multiple questions and topics.

______ 6 Month Career Assistance $1500 $875

Unlimited e-mail consultation and support. This option puts you in an on-going dialogue with me for up to 6 months and includes 2 telephone sessions, including 2 telephone calls with Jay.

______ 12 Month Career Assistance $3000 $1750
Unlimited priority correspondence for on going support and direction, including 4 telephone calls with Jay. 

I've found that many of my clients need on going support as we reach each new plateau. Career development needs continuity in consultation and direction. This package will put me on your team for up to a full year. Includes 4 telephone sessions.

PLEASE SELECT A PLAN ABOVE AND MAIL THIS ORDER FORM WITH YOUR CHECK/MONEY ORDER/CASHIER'S CHECK OR BANK DRAFT TO:

Jay Jacobs

78-365 Highway 111 #178

La Quinta, CA 92253 USA

I will contact you upon receipt of your order.