FormsFILL THE CREDIT CARD INFORMATION AND AUTHORIZATION FORM HEREClick the links below to visit our other form pages NEW TAIS ACCOUNT INTEREST FORMWINNING MIND TAIS TRAINING GENERAL INTEREST INQUIRY FORMNEW TAIS ACCOUNT CREATION FORM (TO EPS)CREDIT CARD AUTHORIZATION Card Type Visa, Mastercard or American Express Cardholder Name * Please enter the name as it appears on the card TAIS / Account Name (if applicable) Credit Card Number * Please enter your card number Expiration Date * Please enter the card expiration date Card Identification Number * Please enter the 3 or 4 digit card security code Billing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Please include a valid email address. Contact Phone * Please include a good number to reach you on if we need to. Country (###) ### #### Authorization * My initials below hereby authorize Winning Mind LLC to charge agreed upon TAIS and Consulting Related fees to the card indicated above. I will notify Winning Mind of any changes to my credit card information or of any desire on my part to change or terminate this authorization. Note Please let us know anything else important Thank you, your form has been submitted.
