Money Order MAIL SUBSCRIPTION FORM

Print this form and fill it out clearly and completely to begin your subscription. Please include your email address so that we can confirm your Username and Password and notify you when your subscription begins.

AKASHAWEB.COM

CUSTOMER'S NAME:

ADDRESS:

CITY, STATE, ZIP:

COUNTRY:

EMAIL:

USERNAME (6 character min/8 character max):

PASSWORD (6 character min/8 character max):

 

WEBSITE IS FOR VIEWING BY LEGAL ADULTS ONLY

By signing this form I am stating that I am over 18 years of age and aware that this is adult material with bondage and discipline themes. I am also aware of my local laws and am taking full liability for website contents.

Signature:                                                                                           Date:

 

Subscriptions Available By Mail:
Payment method: Money Order
(INTERNATIONAL MONEY ORDERS MUST BE IN US FUNDS)

(check option)

____ 6 months for $69.95

____ 30 Days for $19.95

DO NOT SEND CASH.

Please make money order payable to THE STOCKROOM and mail to:

Akasha Ronkay
6285 E. Spring Street #311
Long Beach, CA 90808
USA

** EMAIL ME when you have mailed this form so I know it is coming

Questions?
akasha@akashaweb.com