NON CREDIT CARD MEMBERSHIP SIGN UP PAGE

Please fill in ALL the non-optional boxes on this form and then print it out, sign it and send it to:

Dita's Fan Club / dita.net,
P.O. Box 1760,
Eagle, ID,
83616,
USA

Allow 2 to 3 weeks for order processing. Email sales@dita.net with any inquiries about order progress stating this was a non-credit card order. Memberships will run from date of activation of your account. Auto rebilling is not an option for non-credit card sign ups. To renew your account without break in service send a new check/money order with your account details (username) at least 3 to 4 weeks before your account expires. 6 Month accounts are 2 x 3 month accounts (no further discount) and are provided here and not as credit card options purely for the convenience of those paying by check to take into account the time taken to process payments.

N.B. 1 monthly memberships are no longer available by check or money order.

3 months ($41.95):	(select one)
6 months ($83.90):	(select one)

Name:
Email:
Address:
City:
State/Province/County:
Postal/Zip Code:
Country:
Phone (optional):
Fax (optional):
Desired Username: (at least 6 characters)
Desired Password: (at least 6 characters)

NOTE: If we cannot allocate your username and password due to someone else having already chosen it we will add a random number to the end of what you have chosen and inform you by email. If you prefer to choose a different username/password at that point we will change it for you as required providing your next choice hasn't also been taken

I hearby state that I have read and agreed with the dita.net membership terms and conditions and I am of legal age in my state to receive this material and that it is legal for me to receive such material in my country.

Signed: __________________________________________________________ (use INK)

Print Name: __________________________________________________________

Please attach a photocopy of your passport or other item with proof of your age on it. Do not send original documents as we cannot return them.

ENCLOSE PAYMENT AS A CHECK or MONEY ORDER FOR THE APPROPRIATE AMOUNT INDICATED ABOVE. CALIFORNIA RESIDENTS PLEASE ADD 7.25% SALES TAX. INTERNATIONAL ORDERS ONLY ACCEPTED AS INTERNATIONAL MONEY ORDERS OR CHECKS WITH USA BANKS.