Instructions:

1. Print this form out on your computer.
2. Fill out this form completely.
3. Enclose this form and your payment.
4. Mail to the address below.
5. Wait for an email notifying your account acticvation.
Email Address __________________________________________________
Full Name ______________________________________________________
Address: _______________________________________________________
City: ___________________________________________________________
State: __________________________________________________________
Zip: ____________________________ Phone: ( ____ ) _____ - _________
Country: _______________________________________________________
All usernames and passwords must be in lowercase, and have a minimum of 4 letters and 2 numbers.
Prefered Username 1) ___________________ 2) _____________________
Enter two choices in case one is taken.
Prefered Password 1) ___________________ 2) _____________________
 Enter two choices in case one is taken.
We will email you when your account is activated.
Your payment MUST be made in US FUNDS ONLY!

Please choose one:
(  )US$30.00 for 3 months + $10.00 for each additional month.
(  )US$65.00 for 120 days + Free XXX DVD.

and send payment along with this form to:

CJP
PO Box 42701
Santa Barbara, CA 93140
U.S.A.

Thank You For Your Order!