Boss Waiting List

Please complete the following information to be placed on ITEM’s waiting list for the Brain Optimization and Synchronization System™.  We will not share this information with anyone, and the submission of this information creates no obligation whatsoever.  We will contact you as soon as BOSS™ is available with more detailed information.  Required fields are indicated in bold.  After pressing the “Submit” button below, you will be redirected to the BOSS™ home page.

Contact Information

First Name:   Last:
Street Address:
City:  State/Province:
Zip/Postal Code: Country:
Home Phone:-   Work:-
FAX:-
E-Mail Address:
Company:
Website:

Questionnaire (Optional)

Occupation: 
Describe How You May Use BOSS™:
Are You Interested in Purchasing or Leasing BOSS™ (Check One):   Purchase   Lease
Are You Interested in Becoming a Distributor of BOSS™?:   Yes   No