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Choose the Inner Circle Option you prefer:

	Basic Inner Circle Membership	$5,900US	You receive: 3 binders, all special reports, 14 hours of phone consultation, 12 monthly strategy consultations, the Inner Circle Letter, PLUS unlimited phone help while putting together your market position, mission and Nine Master Keys Instruments.
	Inner Circle Gold Membership	$7,000US	You receive: Everything in the Basic Membership package PLUS free admission to the January Speaking Business Boot Camp and Spirit-of-the-Speaker Retreats AND the June Mastermind Weekend -- or all audio albums that we record at these events.
	Inner Circle Diamond Membership	$9,200US	You receive: Everything in the Basic and Gold Membership packages PLUS the opportunity to meet with Burt and other Diamond members for three full days each year of your membership.

Shipping Method: Choose OneUSA Priority Mail - $23All N. America Next Day Air - $77All Other Countries - Air Express - $105US Investment Option: Standard Installment     Alternative – First-Year in Full

I am paying in full, my check for ______________________ is enclosed.  I would like to use the Installment Plan and I am including twelve checks dated one month apart. (Use this information for amount of checks.)
Credit Card: Visa MasterCard Discover American Express	Credit Card #:	Exp. Date:

Print out and mail to: Personal Achievement Institute 1 Speaking Success Road Kingman, AZ 86402-6543