*Required

Check here if any of the above INFORMATION HAS CHANGED since your last order.

Check here if you are a NEW CLIENT.

*Your First Seminar Date: (click on calendar icon to pick your date)

*Age:

*Household Income: Please Select $30K+ $40K+ $50K+ $75K+ $100K+ $125K+ $150K+ $30K-$39,999 $40K-$49,999 $50K-$74,999 $75K-$99,999 $100K-$124,999 $125K-$149,999

Net Worth (optional cost) $100,000+ $150,000+ $250,000+ $500,000+ $750,000+ $1,000,000+

Other (may incur optional cost)

Investable Assets (may incur optional cost)

We recommend doing an initial radius search for your first list research report.

*Provide only 1 zip code for Radius Search:
Zip code to use as epicenter to run radius count from:      
Miles:      

OR

Provide at least 5 zip codes from your mailing area:

Message:

A copy of this form will be emailed to you at the above email address.

IMPORTANT NOTE: Please read carefully and then check here
By checking this box, you understand and agree to the following:

RME is NOT responsible for cross-over mailings between planners. As a representative of my company, we agree to not duplicate in any way or form the Seminar Success Mailing Program, concept or any of its components protected under intellectual property of RME ®1995. We CANNOT check other zips being mailed and do not offer exclusive territories. All major national lists are compiled by census tracts and other variables that make up a formula. List are NOT 100% accurate because all information and demographics are inferred. Deliverability and accuracy can be anywhere in the 95% to 97% ratio. Lists rarely encompass 100% of the population of the zip codes.