Punished Brats
Membership Mail Order Form
Please print neatly
Select membership option:
______ ..... 30 day membership ($22)
______ ......90 day membership ($58.50)
User ID:.
______________________________________________________________________________
..................Enter
desired User ID. Must be at least 6 characters in length.
Password:.
____________________________________________________________________________
..................Enter
desired password. Must be at least 6 characters in length.
Email Address: _________________________________________________________________________
..................Be
sure to enter your email address so we can send notice of membership access
activation and confirm ID and password.
Payment - Please circle
one: ..... Check ......
Money Order
Make check or money order
out to PB Productions
Please note if paying via
check, membership will not be activated until payment has cleared
I hereby certify that I am at least 18 years of age.
SIGNATURE: _________________________________________
Send completed order form to:
PB Productions
P.O. Box 413
Doylestown , PA 18901