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Enrollment Application

1. Company Information
Name/dba* Federal ID#*
Mail Address* County
City*     State* Zip*
Physical Address*
City*     State* Zip*
Phone*     Fax Cell #
State of Registry* Entity Type*
Principal State(s) of Business* Usual Job Tier
Trade(s) or Profession*
 
Projects Value Range:  Low 
   High 
Projects per Year 
Number of Employees*
 
2. Contact Information
First Name*
Last Name*
 
Title*
Cell Phone
Email
Alternate Contact
Alternate Email
Additional Parties
Best Time
3. Select Your Service Plan
Service Plan FAX Orders & Updates Online Order Online Reminder Report E-mail Reminder Report E-Lien Alert Fee
Standard Service           Included
DateWatcher©™ Track, and get notified of critical lien event deadlines + $600 / yr
WaiverBuilder©™ Unlimited, self generation of Custom Lien Waivers + $300 / yr
4. Trade or Professional Memberships
5. Charges and Invoicing
There is a One-time new client origination fee of $200 plus any charges that may apply to the service plan you select. Add fee for Service Order(s) you submit now. (Request more information for details.)
You will be given an opportunity to verify your information and the amount due before any charges are incurred.
  Payment Options
Solution Graphics
After clicking "Send" below, you may choose to pay by credit card now or pay by check.
 

After payment is processed and your account is activated, you will receive full access to the website features, including online service orders.

6. Web Access
Create for yourself a username and password for access to your online account features (all lowercase, no spaces).
User name:
Password:
7. This application for enrollment subject to terms of Service Agreement and is not a contract until and only if accepted in writing by both parties. Limited offer. Terms and Conditions apply at time of use.
Authorized Representative*:

Service subject to ALP Service Agreement.

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ALL fields must be filled in to process your request
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Disclaimer: ADVANTAGE LIEN PROTECTION, LLC IS NOT A LAW FIRM AND DOES NOT PROVIDE LEGAL ADVICE.
12065 W. Janesville Rd. • Hales Corners, WI 53130 • main: (414) 529-5878 • fax: (414) 529-5887
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