Date Like a Queen Program - Sign-up Page

Date Like A Queen Signup & Pay

First Name

Last Name

Email

Address

Address Line 1

Address Line 2

Suburb / City

State

Post Code / Zip Code

Country

Phone/Mobile

I have read and agree to the Terms and Conditions

Payment Option

Pay $3,000 AUD In full now

Pay in 3x $1,200 AUD monthly installments

Payment In Full (to be paid now)

Price: $3,000

Monthly Payment Plan

$1,200 for each month, for 3 installments

Pay with Card (Stripe)