Your Information

Type of Membership: The '80s Server -- Music Fan Clubs
Duration of Membership: One Month ($4.95)
One Year ($39.95, 11 cents a day!)
First Name:
Middle Initial:
Last Name:
Street Address:
Apt/Suite #:
City:
State (U.S. only):
Province (Canada only):
Country:
Zip/Postal Code:
Day Phone:
Home Phone:
E-mail Address:


Giftee's Information
First Name:
Middle Initial:
Last Name:
E-Mail Address :
Phone :
Do you want the free mousepad? Yes -- No
When would you like us to contact the recipient:


Payment Information

PAYMENT METHOD:
Credit Card -- Check or Money Order
IF CREDIT CARD:

Type of card:
Card Number:
- - -
Expiration Date:
IF CHECK OR MONEY ORDER:

Make check payable to:
The '80s Server
Or MusicFanClubs

Send payment to:
The '80s Server
Or MusicFanClubs
8650 College Blvd. Suite 111
Overland Park, KS 66210

Your account will be activated upon receipt of payment.
Have questions? Need help? E-mail us!