The Sexiest Women Alive.Com Mail Order Form

Please complete the following fields and mail this form with payment to the address below
Name:


Address:


City/State/Zip:


Country:


Telephone Number:


Birth Date:


Email Address:


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Membership Type:
Package #1 - SWA 30 Day - $49.95
 
Package #2 - 90 Day w/Free 90 Days - $79.95
 
Package #3 - 365 Day w/Free 365 Days - $139.95
 
Signature:


Please note by completing and signing this form you are verifying that you are 18 years or older.

Mail completed form along with Money Order to:

The Michael Scott Company
PO BOX 683
Lewis Center, Ohio 43035