Mitchell 1 ProDemand Signup

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Contact Information

Name*

First Last

Contact Phone Number*

Contact Email*

Company Information

Please provide the company information

Company Name*

Company Phone Number*

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Physical Address (if different from Billing Address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing Frequency*

All prices are in US dollars. You will enter a referral code below which will establish the discount and final recurring cost.

Quarterly Subscription of ProDemand

This is the base price for your 3-month ProDemand billing cycle (before any discounts). You’ll be charged this amount less any discounts every 3 months. Please note: pricing may increase after the first 12 months.

Price: $0.00

Annual Subscription of ProDemand

This is the base price for your 12-month ProDemand subscription (before any discounts). You’ll be charged this amount less any discounts once per year. Please note: pricing may increase after the first 12 months.

Price: $0.00

Referral Code

If you have a referral code, please input it here.

Total

Your credit card will be charged today for this amount and then every 3 months for quarterly subscribers and every 12 months for annual subscribers. Amount is in USD and subject to price increases after 12 months.

Credit Card Info*

This will be the Credit Card charged each selected billing cycle.

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

I understand that this is a 1 year contract and I am obligated to continue to pay 1sixty8 media for this service for a period of 1 year from today.*

I agree to this

I understand that my credit card will be charged today for the amount indicated below and then every 3 months for quarterly subscribers and every 12 months for annual subscribers. These charges will continue until I notify 1sixty8 media via email (mitch@1sixty8.com) to discontinue.*

I agree to this

I understand that this subscription is for 1 license to access on up to 5 devices at a time in one physical location. I understand that it is against the policies of Mitchell 1 to share login credentials with other locations. If Mitchell 1 determines that my subscription is being used at multiple locations, they will suspend my subscription.*

I agree to this

I understand that it is my responsibility to verify accuracy of all data provided in ProDemand. I hold 1sixty8 media and Mitchell 1 harmless in the event of any damage resulting from the information provided in ProDemand.*

I agree to this

Signature*