I am over the age of 18 years (sign) ......................................................
Name: ..............................................................
Desired Usrid (6-8 characters) ...................Desired Password (6-8 characters) ...................
Choose a Usrid that you do not think anyone else would use. You can have the same Usrid/Password all of your purchases.
Your email address ...........................................................................................................
Personal Checks and Postal Orders from countries other than Australia NOT accepted
GND,
PRINT REALLY, REALLY CLEARLY
You will be notified by email when your membership is set up.
30 days Membership of AdultBaby.xxx
(Tick) ...... US $24.95
(Tick) ...... EUR 20.00
(Tick) ...... GBP 17.00
(Tick) ...... AU $40.00
30 days Membership of Xtreme diaper
(Tick) ...... US $29.95
(Tick) ...... EUR 24.00
(Tick) ...... GBP 20.00
(Tick) ...... AU $47.00
90 days to download Family Album Jan to June 2004
(Tick) ...... US $60.00
(Tick) ...... EUR 48.00
(Tick) ...... GBP 40.00
(Tick) ...... AU $95.00
90 days to download Family Album July to Dec 2004
(Tick) ...... US $60.00
(Tick) ...... EUR 48.00
(Tick) ...... GBP 40.00
(Tick) ...... AU $95.00
90 days to download Family Album Jan to June 2005
(Tick) ...... US $60.00
(Tick) ...... EUR 48.00
(Tick) ...... GBP 40.00
(Tick) ...... AU $95.00
90 days to download Family Album July to Dec 2005
(Tick) ...... US $60.00
(Tick) ...... EUR 48.00
(Tick) ...... GBP 40.00
(Tick) ...... AU $95.00
90 days to download Family Album Jan to June 2006
(Tick) ...... US $60.00
(Tick) ...... EUR 48.00
(Tick) ...... GBP 40.00
(Tick) ...... AU $95.00
Total $............ Enclosed
If you send cash more than that required for 30 days membership
we will extend your membership additional days pro rata.
IMPORTANT -
Accepted:
Cash, Bank Cheques, Cashier's Checks, Money Order, Australia Post Postal Orders
Make in favour of: "GND"
Print out this form and mail to:
P. O. Box 582,
New Farm
Qld 4005
Australia