|
Join
Jump Jessie by Snail Mail |
|
|
. |
|
30 days non-recurring
access to not just my own Web Site, but the Entire Hot Web Amateurs Network
... All for just: |
|
30 Days - £20.00 |
60 Days - £35.00 |
90 Days - £45.00 |
|
. |
|
Please print out the
following form, complete (print clearly) and post to me. |
|
. |
| Forename* |
: |
_______________________ |
|
. |
| Surname* |
: |
_______________________ |
|
. |
| Address* |
: |
_____________________________________ |
|
. |
| Address 2 |
: |
_____________________________________ |
|
. |
| Town / City* |
: |
_______________________ |
|
. |
| County* |
: |
_______________________ |
|
. |
| Post Code* |
: |
____________ |
|
. |
| E-Mail Address* |
: |
_____________________________________ |
| |
|
This is where we will
mail your Sign-up Confirmation. |
|
. |
| Subscription* |
: |
30 Days __ : 60 Days __ : 90 Days __ |
| |
|
Please tick applicable
subscription. |
|
. |
| Username* |
: |
____________ |
|
. |
| Password* |
: |
____________ |
| |
|
Please make your Username
& Password 6 characters long and try to use uPpeR aNd lOwEr Case letters |
|
. |
| * |
: |
Mandatory |
|
|
. |
|
Please make Cheques & Postal
Orders payable to: Black Coffee No Sugar Limited |
|
(Allow up to 7
days for Postal Orders & 14 days for cheques) |
|
. |
|
Then post to: |
|
Black Coffee No Sugar Limited |
|
Coastal House |
|
180 Bridge Road |
|
Sarisbury Green |
|
Southampton |
|
SO31 7EH |
|
. |
|
|