A Pretty Woman
Please print and fax to:  

Fax in USA at: 1-561-828-2228  Fax international at: +1-561-828-2228

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Enter girls reference numbers below
Addresses 1 - 4 $15.00 each, 5 - 9 $12.00 each, 10 or more $10.00 each     Letters Letter are $5.00 each
Addresses and letters Addresses only Letters only

 
Optional memberships below

		Standard membership	$145.00
		Super membership	$195.00
		Deluxe membership	$295.00
		VIP membership	$495.00

 

		Basic personal listing	$150.00
		Premium personal listing	$350.00

 

		Tour deposit	$350.00
		Writing Tips	$30.00
		Fiancee Visa Kit (how to bring your lady to USA)	$60.00

 
 
 

Enter your personal information here
First Name	Last Name
Street Address
City	State (province/region)	Zip (postal code)
Country	email
Fax	Phone

 

Select a payment method
Visa Master Card American Express Discover Card	Money Order Personal Check Cash Western Union Moneygram Wire Transfer +US Dollars 15.00
Credit card is the preferred method of payment. If you choose another payment method we will send you payment instructions.

 

Enter your credit card information here
Credit card Number
To find your CVV2 number turn your credit card over, and on the signature strip will be printed your credit card number plus an additional 3 numbers. The 3 additional numbers is your cvv2 number and must be entered here. American Express, it's a 4-digit number on the front of the card, above the account number.
CVV2 number	Expiration month	Expiration year
Credit cards issued in United States, addresses and zip codes are compared with bank records using AVS. If your billing address is the same as you entered above mark this field.
Otherwise enter your billing address below.
First Name	Last Name
Street Address
City	State	Zip
Country

Total amount of order      $
Signature	Date
If payment by credit card I authorize you to charge my credit card the above amount.

 

Comments:

 
Note: We cannot accept American Express credit cards for tour deposits.

Fax in USA at: 1-561-828-2228  Fax international at: +1-561-828-2228

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