Ron LeGrand's Platinum Inner Circle Application Ron LeGrand' Platinum Inner Circle Application Name * Do you have children? No Yes Number of Children Ages of Children Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Cell Phone * Email Address * Do you currently have a website? No Yes Website Address Are you an Info-Marketer? No Yes Full Time/Part Time Full Time Part Time How Long? What Industry? What Do You Sell? Business Annual Income * Do you consider yourself a leader? No Yes Can you take input without being argumentative? No Yes If you are human, leave this field blank. Next