www.dirtydirector.com

JOIN BY MAIL FORM

 

Please print out the following form, fill it out "neatly" payable to Southbound Productions, attach cash or money order and mail to:

MAIL BOX NOW CLOSED


_______________________________________________
NAME: _____________________________________________________________
Street Address:________________________________________________________
City/Town:___________________________________________________________
State/Providence:______________________________________________________
Country:_____________________________________________________________
Postal Zip Code:________________________
e-mail Address:________________________________________________________

The added effort to manually create an account forces us to raise the membership dues by 5.00:

Subscription length Desired:
30 day membership ________ $35.00 U.S. Dollars
6 month membership________$100.00 U.S. Dollars


Username:__________________ (max of 8 characters)
Password:___________________(max of 8 characters)

YOU WILL BE NOTIFIED BY E-MAIL AS SOON AS YOUR ACCOUNT IS ACTIVATED.

I CERTIFY UNDER THE PENALTY OF PERJURY THAT I AM OF LEGAL AGE IN MY AREA OF RESIDENCE TO VIEW IMAGES AND
TEXT MEANT FOR MATURE AND ADULT AUDIENCES.

SIGNED:________________________________________

DATE:__________________

 

 

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