LindaTran.net Membership Order Form

Please print and mail to:

LT Memberships
2700 Rose Avenue
Suite O
Signal Hill CA 90755

Standard Monthly Membership
$25.00 for thirty (30) days
__________ Months x $25.00
 
Mail Order Special!! Six (6) Month Membership
$100.00 for one hundred eighty (180) days (like getting 2 months free!)
Mail Order Special!! One (1) Year Membership
$175.00 for three hundred sixty five (365) days (like getting 5 months free!)

Number of Months of Membership: __________
Total Amount Enclosed: __________

Username: Password:

Customer Information

First Name: Last Name:
Address:
Address (cont.):
City/Town:
State/Province: Zip/Postal Code:
Country:
Email: Birthdate:

Please make all MONEY ORDERS or CERTIFIED CHECKS payable to Linda Tran.
Note: NO personal checks accepted. Payment must be made in U.S. funds drawn on a U.S. bank. Send cash at your own risk.

Please sign and date below to certify that you are at least eighteen (18) years of age.

Signature: ______________________________________     Date: ___________________