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XXXBASEMENT.COM POSTAL MEMBERSHIP SUBSCRIPTION FORM |
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Membership fee is payable in US Dollars (cash only) and amounts to US $50 for one year access. ( We do NOT accept checks or money orders!)
Type into the 4 boxes below, print the form, sign it and
mail it to us at the address above.
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Your E-Mail Address: |
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| Your Name: | |
| Desired Username: | |
| Desired Password: |
By signing this form you hereby represent and warrant that the following statements are true:
Further to the above, signing this form shall constitute an implicit acceptance of the agreement/disclaimer posted on the www.xxxbasement.com website's main page.
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Please e-mail WEBMASTER@XXXBASEMENT.COM in order for us to activate your account as soon as payment is received.
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