Purchaser Information

* First Name

* Last Name

Company Name

* Address - Line 1

Address - Line 2

* City

* State

* Zip Code

* Phone Number

* Email Address

Practice Name

What is your firm's primary practice area?

Payment Information
Credit card
Card type	Card number	Expiration Date	CVC

Payment Information

Credit card

Card type

Card number

Expiration Date

CVC

Products Price Quantity Total

Products		Price	Quantity	Total
Great Practice Essentials Initial Deposit	$295.00	Update	$295.00
Great Practice Essentials $695.00 / month	$695.00	Update	$695.00
Subtotal			$990.00

Great Practice Essentials Initial Deposit

$295.00

Update

$295.00

Great Practice Essentials

$695.00 / month

$695.00

Update

$695.00

Subtotal $990.00

Order Summary

Subtotal $990.00

Order total $990.00

Order Summary
Subtotal	$990.00
Order total	$990.00
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PROGRAM COST
Atticus Great Practice Essentails is $295 down PLUS $695/mo with a 3 month minimum committment. Your cost today is $990 ($295 setup + $695 for your first month).

By submitting this form, you hereby authorize Atticus, Inc. to charge your credit card monthly until you choose to terminate this membership. *

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