Order by mail

(1 month memberships are not sold via mail)

(Print Form)

Enter site name here :_________________ Membership Options       Price per Item   Total
Enter site's URL here:
_________________________________
Be sure to enter your
email address.
Please include the
site name & url.
_____
Enter YOUR email address here:
_________________________________
3 months $30.00 _____
All user information must be filled out.
REQUESTED 
USER ID:
_______________
REQUESTED
PASSWORD:
___________


x_____________________________
Please sign here... I am 18 years and older.


Please make Check or Money Orders payable to:
Michael Gardner
Mail order form to:
Michael Gardner
P.O. Box 2902
Harvey, LA. 70059
ONLY U.S CASH, U.S CHECK and U.S. MONEY ORDERS ACCEPTED