Congratulations Lois Lane!

Your Account ID is 0123456789.

Please write this information down for future access to our site.

You are entitled to a discount!

Purchase a plan this week for 20% off of the regular price.

Your discount is valid until

October 30, 2006!

Plan

Please select a plan from the options below.

Plan Duration Regular Price Your Price
Individual
Your application for 1 year
1 Year $69 $49
Individual
50% discount on 2nd year!
2 Years $89 $69
Individual
Best Value: Free Year!
4 Years $139 $119
Couple
You and Your Spouse - Double Your Chances!
1 Year $99 $79
Couple
70% discount on 2nd year!
2 Years $119 $99
Couple
Best Value: Free Year!
4 Years $219 $199
Life Time Application - Until You Win!
We submit you and your family every year until you win!
$549 $499

Payment

Please select a payment plan. Credit Card and PayPal are highly recommended.

Credit Card PayPal Western Union Cashiers Check Cash
PayPal PayPal Western Union Cashiers Check Cash
Credit Card Type
Credit Card Number
Expiration Date
Name
As it appears on your credit card
Identification Number Your Identification Number can be found on the back of your card:
Billing Address
As it appears on your credit card statement
Optional
City or Town
Province or State Canada or USA only
Country
Postal or ZIP Code
Credit Card Fraud Watch

Use of a stolen or fraudelent credit card number is illegal and results in permanent disqualification! We will prosecute all cases of fraud.

Your IP address has been recorded to prevent fraud: 216.143.122.3

I agree to the Terms and Conditions
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  • The Couple option should not be displayed if the user has indicated that he or she is not married (on EQ1B)
  • If the user selects a Province or State, then the options of the Country menu should dynamically udpate such that only Canada and the United States of America are options.
  • If the user first selects a country other than Canada and the United States, then the Province or State menu should be disabled.