CASH PAYMENT FORM

*************** PLEASE PRINT THIS PAGE ***************


* Fill in all the applicable information completely
* Be sure your e-mail address is accurate, this to send you your password
* Please, send me an e-mail to let me know you have sent your order: info@boy8teen.com
* A refund of your money is not possible with cash payments 
   
We accept the following currencies as cash or traveller cheque payment:
 1)  US Dollar (USD)
 2)  Euro (EUR)
 3)  Great Britain Pound (GBP)
 4)  Canada Dollars (CAD)
   
Mail the application and make payable to: 
 CompuWorld
 PO-Box 10
 1850 AA HEILOO
 The Netherlands
 

 Name:  
 E-mail:  
 Desired Username:  
 Desired Password:  

 Please choose your membership option:

 Duration

 Price

 Check one
 

 USD

 EUR

 GBP

 CAD
 

 1 Month

 20

20

 12

 28
 

 3 Months

 50

50

 30

 68
 

 6 Months

 65

65

 40

 88
 

  By signing below I agree to the Disclaimer and I certify hereby that I am at least
  18 years of age.
 Signed on:  
 Signature: