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Print out this form and sign, print your email addres and other info. If you do not have a printer, you may write out the information and mail it to the address below. Your information will not be given out, sold or distributed and you will not receive spam either via email or snail mail. You are providing it here for membership to www.SmotheredSlave.com ONLY! Print and mail this form to: Allusion Studio 17939 Chatsworth st. Suite #294 Granada Hills, CA 91344 Under penalty of perjury, I swear that I am over 18 years of age and am making this payment for access to www.SmotheredSlave.com. Legal Name___________________________________________________________ Address _____________________________________________________________ City/State/Zip ______________________________________________________ Country _____________________________________________________________ Email Address _______________________________________________________ Signature_____________________________________________________________ Circle One of the following choices 30 Days membership - $29.95 90 Days membership - $54.95 You must include the exact amount for the above choice, no change will be given. Make Checks, Money Orders or Cashier's checks Payable to: Allusion Studio Personal checks are very slow to process. Money orders and cashier's checks process faster. We are not responsible for lost payments. We are not responsible for stolen cash. Cash is accepted in $US only. You must have an email address and send it with payment so we can get back to you with your login information. Your desired username/password combination may be taken, so this is very important. If you do not send an email address your payment will not be processed. Username____________________________ Password____________________________ |