TO JOIN CLUB RENEE WITH MONEY ORDER OR CHECK

Please print this form....fill it out completely!!!  Sign your legal name and mail it along with your CHECK, MONEY ORDER, TRAVELER'S CHECK or CASH to the address provided below.

 

Your NAME:__________________________________________________________________

Date of Birth:____________________  Age:__________  (this is a test!!!)

***YOUR EMAIL ADDRESS:_____________________________________________________

***you will be notified by email when your username and password take effect....please double check that you have submitted the correct email address!!! 

Term of membership that I desire:  _____1 month - $15.00(US) enclosed

                                                        _____3 month - $40.00(US) enclosed (free cd-rom video)

                                                        _____Annual - $120.00(US) enclosed (free video from Renee's Video Page)

Username that I would prefer to use:   ___________________________________

Password that I would prefer to use:   ___________________________________

***we do not guarantee the availability of usernames and passwords.  We reserve the right to change your selection to avoid duplicates or submissions that are too easy to steal.

YOU MUST SIGN AND RETURN THIS FORM or a form that is comparable in nature to:  Make checks payable to National Resource Group or NRG.

National Resource Group, Inc.

PMB 341

11924 Forest Hill Blvd. Suite 22

West Palm Beach, FL  33414

Attn:  RENEE

 

By signing this form, I declare under perjury of law that I am requesting sexually explicit material and am over the age of 18 years (21 in some areas) and it is legal for me to purchase and view the material that I am requesting.

SIGNATURE:_______________________________________________________