Sexy Chase's Membership Form

Thank you for choosing "Pay by Mail". As a 6 month cash paying member you will receive an autographed 8x10 photograph of yours truly, Chase. So please fill out the form completely to receive your "Free Gift".
Fill out this form, Sign it and Return to:

Chase
c/o WorldWide Marketing, Inc.
2375 East Tropicana #272
Las Vegas, NV 89119

Make Checks/Moneyorders Payable to: Worldwide Marketing, Inc.
Before ordering, certify that you are 18 years of age or older, that you are familiar with all local laws in your area affecting the viewing of pornography; that you have the legal right to purchase adult oriented material and AngryJohnny Productions has the legal right to show it to you; that you guarantee the adult oriented material you are ordering will not be used for anything other than your own private enjoyment and will never be shown or given to a minor by signing below.

Signature ______________________________________ Date __________________

First Name_____________________ Last Name______________________________
(print)
Street__________________________________________________________________

City________________________ State_____________ ZIP____________________

_______ $15.95 for one month
_______ $35.00 for three months
_______ $60.00 for six months

Please confirm my order via email at: _________________________________
Requested Username: _________________ Password: ___________________
_______ Add me to your mailing list
_______ Enclosed is $12.00 more for an 8x10 Photo of Sexy Chase
_______ Enclosed is $ 7.00 more for a Sexy Chase Magnet
Thanks for Joining By Mail!