Name First Last PhoneEmail Booking Date YYYY dash MM dash DD Time10:00 AM10:30 AM11:00 AM11:30 AM12:00 PM12:30 PM01:00 PM01:30 PM02:00 PM02:30 PM03:00 PM03:30 PM04:00 PM04:30 PM05:00 PM05:30 PM06:00 PMThe “Let’s Connect” The “Let’s Connect” $539.98 /Month This plan includes: A subscription to two 1-hour sessions of conversation each week for a month.Payment InformationCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name Total
