Best-seller Book Affluence Sign Up Form

Put
THE MISSING DYNAMIC
Into Your Life and
Reach Your
Ultimate Level of Success!

Congratulations in making the decision to speak with Robert S. Nahas over the possiblility of getting on his list for writing a best-seller quality book for you this year.

Please realize that you are NOT automatically one of my selectees simply because you have filled out the form below. I have a screening process where I speak with each person, one-on-one. The criteria is pretty simple, but essential to great success:

You must be:

A hard worker.
Someone who is a go-getter!
An individual who thirsts for great success!
Financially qualified.
Your endeavor is something that helps improve conditions for others.

Once my personal quota limit has been reached, the
screening process will discontinue without notice.

NOTE:
- There is no obligation.
- You must fill out the form completely to be considered for this program.
- Your information stays safe and is NEVER shared, rented or whatever else the unethical SPAMMERS typically do.

No Obligation Sign-up Form

Full Name:

Company:

Address:

City:

State:

Zip Code:

Phone 1:

Phone 2:

Best time to reach you: (include time zone: East Coast, Central or Pacific)

E-Mail:

Please confirm your e-mail:

1. What is most important to you?
Wealth
Fame
Being in Demand
Having Credibility
Being the Top Person in Your Field
Other (please explain):

2. What symbolizes success?

3. Do you believe that being an author of a book would help you to be more successful?
Yes
No

4. Why haven't you written/published a book?

5. What would be the reason(s) that you would have a book made?

6. What is your ultimate goal with your business/career/life?

7. a) Are you satisfied with your level of success?
Yes
No

7. b) Why?

8. How did you find me?