AIM WORLD APPLICATION FORM (USA)

Interested to Join AIM WORLD?

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APPLICATION FORM

Please make sure to double check all your informations.
COMPLETE NAME:*

First NameLast Name
Birth date:*

MonthDayYear
Beneficiary's Name:*

First NameLast Name
E-mail*
Name of your SPONSOR ( the one who INVITED you ). If you have no SPONSOR, just type NONE.

First NameLast Name
Choose your Global Package:*

Sapphire $288Emerald $864Diamond $1,440
+ SHIPPING RATE:*

Sapphire $25Emerald $102Diamond $127
TOTAL:
Do not forget your TOTAL Amount.
SHIPPING DETAILS:

Please indicate your COMPLETE Shipping DETAILS to prevent your package to put on hold.
SHIP TO:*

First NameLast Name
Phone Number*
SHIPPING ADDRESS:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Your Message:
Should be Empty:

APPLICATION FORM