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Mistress Maggie |
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It will be
useful to me if you print and complete this form and send it with your payment. Please write
clearly in NEAT BLOCK CAPITALS if I cant read your eMail
address |
| Forename:________________________ Surname:______________________________________ |
| Preferred username (512 letters or numbers):______________________________________ |
| Preferred password (4 or more numbers):______________________________________ |
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Current E-mail address:___________________________________________________________ |
| Confirm E-mail address:___________________________________________________________ |
I enclose £10 for 30 days membership |
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Signed:______________________________________ |
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Post to:
MMDC |