WELCOME TO TWISTED QUEEN FINANCIAL & TRAVEL LLC

New Member Enrollment

First Name *

First Name Spouse

Last Name *

Last Name Spouse

DOB *

DOB

Last 4 of Social *

Last 4 of Social Spouse

City *

Address *

State/Province *

Zip/Postal Code *

Phone *

Phone Spouse

Email Address *

Email Address Spouse

What Twisted Package Are You? *

Twisted Membership *

Preferred way to contact *

Phone

Email

Any

Preferred way to contact Spouse

Phone

Email

Any

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

CVC *

Who Referred You? *

Terms and Conditions *

You consent to receive communications from us electronically. We will communicate with you by e-mail or phone. You agree that all agreements, notices, disclosures and other communications that we provide to you electronically satisfy any legal requirement that such communications be in writing.

Please sign *

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Please sign

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Black Friday Sale

Twisted Effect Single	Twisted Couples Affair	Twisted Experience Single
Twisted Couples Experience Express	Twisted Travel Regular Membership	Twisted Travel VIP Membership