Mail Order Form

Are you interested in joining, but don't want your significant other to find out you put a charge on the card?  No problem, because now you can!  All you have to do is send cash in U.S. dollars or a money order directly to:

Box Holder
P.O. Box 7352
Seminole, FL 33775

**IF SENDING A MONEY ORDER PLEASE MAKE IT PAYABLE TO "R.J. & R.J.'S ENTERPRISE INC"**

Please print and fill out this form
and mail it with your payment to the above address.

No orders will be filled without returning this age verification order form with payment.

 

     My name is: ________________________________________

     My E-mail address is: _________________________________ (a private one ;)

     I am enclosing in U.S. dollars:

 
 $24.69 / 30 days

 
 $59.69 / 90 days

 

I declare under the penalty of perjury to the following:

  • I am at least 18 years of age.
  • I will not exhibit this material to any minors.
  • I am not ordering for the purpose of entrapment.
  • I am not affiliated with any postal or law enforcement agency.
  • I personally warrant that the material I am requesting is acceptable and meets my community standards.

**All cash is sent at your own risk, no personal checks!

 

Signature: ________________________________          Date: ______________

Thank you for joining Club Vanessa!  As soon as this form is received and filled out with your information and payment, you will be sent an e-mail confirmation with your user name and password to access my members area!

I can't wait to see you inside!    xxxoxoxo,  Vanessa :)