A NEW and BETTER WAY of DOING BUSINESS and SAVING MONEY
Print this page...Fill out the form...Mail or E-mail to:
PO BOX 39 DEWEY, AZ 86327
Phone: (928) 772-8849
Name: ________________________________________________________________Title: _________________________
Phone ( ) _____________________________ Web: ___________________________________________________
What does your business sell?
Please be specific – List all categories of items you sell or services you provide.
What Personal Items do YOU have that you would like to make available to other Executive Members?
(Real Estate, Cars, Trucks, Boats, Motorcycles, Equipment, Condos, Furniture, Horses, and other items in good condition
Please be specific – List all details and prices at fair market value.
HOW DO I BECOME AN ARIZONA DOLLARS MEMBER?
All you do is make your products and/or services available to other Members. (You can even make personal items available.)
As an ARIZONA DOLLARS EXECUTIVE MEMBER, I will…
(1) Accept 100% ARIZONA DOLLARS from other EXECUTIVE MEMBERS and 50% from those who are not
(2) Spend ARIZONA DOLLARS with other EXECUTIVE MEMBERS at 100%. (EXECUTIVE MEMBERS must show their
EXECUTIVE MEMBER Card when purchasing)
(3) Receive EXECUTIVE MEMBER Card(s) which entitle(s) me and my staff to make purchases from other EXECUTIVE
MEMBERS with 100% ARIZONA DOLLARS. Number of ID Cards Needed _____
(4) Receive $500 ARIZONA DOLLARS when I enroll a new Business. .
(5) As an ADDITIONAL BONUS … I understand I have the option to participate in the ARIZONA
DOLLARS SAVINGS PROGRAM by paying a ONE-TIME Fee of $250 and RECEIVE 100% REBATES in
ARIZONA DOLLARS for ALL my purchases from other ARIZONA DOLLARS Members. (by simply mailing
my receipts to the ARIZONA DOLLARS office.)
I choose to participate in the ARIZONA DOLLARS PROGRAM (Choose one option below)
_____ FREE EXECUTIVE MEMBERSHIP
_____ ONE-TIME $250 EXECUTIVE MEMBERSHIP FEE (NO OTHER FEES or DUES EVER (RECEIVE $250
ARIZONA DOLLARS upon joining PLUS RECEIVE 100% REBATES in ARIZONA DOLLARS on ALL ARIZONA
DOLLARS I SPEND WITH OTHER MEMBERS.) (make check payable to ARIZONA DOLLARS)
Name: _____________________________ Title: _________ Signature: ___________________________________ Date: ___________
Referred or Signed by ________________________________
YOU CAN USE PAY-PAL to become a MEMBER and RECEIVE ALL the BENEFITS