NOTE:
Only form of payment accepted through mail are money orders in US funds.
First
Name:________________________________________
Last
Name:________________________________________
Address:__________________________________________
City:__________________________State:______________
Zip/Postal
Code:____________Country:______________
Birthdate:_________________________________
Email Address:________________________________
user
name: ____________________________
password: _____________________________
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Membership (Choose One):
•___ 1 Month Subscription - $25.00 (USD)
•___ 3 Month Subscription - $60.00 (USD)
•___ 6 Month Subscription - $100.00 (USD)
Please make money orders payable to Natasha Yi.
NOTE: Money orders
must be in US funds
Thanks for your support! Please allow at least 2 weeks for activation
and include your email address
when sending your payment so we can notify you upon activation of your
membership.
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Signature: __________________________________
Please note by completing and signing this form you are verifying
that you are 18 years or older.
_____________________________________________________________________________
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