amateurgynecologist.com
membership by mail
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form, print, and mail along with your cashiers check, money order, or personal
check to
Eurobahia Partners Ltd.
P.O. Box 11434,
Merrillville, IN 46410 U.S.A.
IMPORTANT
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amateurgynecologist.com. Remember, both are case
sensitive.
Username:_________________________
Password:_________________________
- Email Address:_______________________
- Make checks payable to Eurobahia Partners
Ltd. Payment by cashiers check or money order will
activate your membership upon receipt, personal checks may take up to 10 days
from receipt before membership is activated.
|
Include your payment of $34.95 for 30 day membership, $54.95
for 90 day membership, or $59.95 for a one year
membership. |
PLEASE REVIEW THE
FOLLOWING
- I am at least 21 years of age;
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isn't to be viewed by minors or anyone else but myself;
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or acting as an agent thereof, attempting to obtain any evidence for the
prosecution of any individual or CORPORATION or for the purpose of
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province or country.
All of the above is understood and the following is
true.
I ACCEPT ALL RESPONSIBILITY
I also release amateurgynecologist.com and my internet
service provider from allliability.
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CUSTOMER
INFORMATION
Name
__________________________________________________
Address
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Address
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City ______________________________ State __________
Zip __________
Phone _________________________ Fax
_________________________