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Membership Type	Listen to Freedom From Phobias for 30 Days Online ($49.95) - This will allow you to access the program online from your computer for 60 days. A broadband connection (cable modem, DSL, etc.) is recommended for best performance. You will need to have speakers or headphones connected to your computer. Be sure to write down the user name and password that you choose.
Your Name Your First & Last name
Your E-Mail Address A confirmation email will be sent to you at this address
Choose a Login Name (User ID) It must be 4 or more characters in length and may only contain small letters, numbers, and the underscore '_'	check for uniqueness
Choose a Password Must be 6 or more characters
Confirm your password Enter password again
Source How did you hear about our website or program?
Problem Please briefly describe the general nature of the issue you would like help with (optional).
Enter coupon code if you get any coupon code from advertising, please enter it here