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Amateur Pleasure Broker Mail-In Form |
Please print out this form, fill it out completely and neatly. Attach a money order or cashiers check.
Sorry but no personal checks will be accepted, all monies must be in certified US Dollars.
Please make the money order or cashier's check payable Ashley Evans and send to my EBay Office:
| Ashley Evans |
| c/o Pleasure Broker Corporation |
| 2000 Mallory Lane |
| Ste 130-226 |
| Franklin, TN 37067 |
| My assistant at the EBay office will ensure I receive notification of you payment and you will be added immediately. |
| Name | |
| Street Address | |
| Address (cont.) | |
| City | |
| State/Province | |
| Zip/Postal Code | |
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MAKE SURE YOUR EMAIL ADDRESS IS
LEGIBLE
I must be able to read your email address to contact you when the funds are received |
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Please provide the following ordering information:
_ One month for $15.00 U.S. Dollars
_ Two Months for $30.00 U.S. Dollars
_ Three Months for $48\5.00 U.S. Dollars
Please certify that you are over the legal age in your area of residence and can view images and text of the adult nature meant for mature and adult audiences.
I certify that I am of legal age in my area of residence to view images and text meant for a mature and adult audience.
Signed: __________________ Age: ______ Date:
__________________
You will be notified by e-mail as soon as your account is activated.