MONEY ORDER FORM
Western Match P.O. Box 20054 Fountain Hills, AZ 85269-0054
__________________________ First & Last Name: __________________________ Email Address: __________________________ Username:		Membership Amount: Check membership below. ____ $12.95 One Month Membership ____ $16.95 Three Month Membership ____ $26.95 Six Month Membership ____ $36.95 One Year Membership ____ $50.00 Lifetime Membership
Snail Mail - Print out this form and mail it with your money order. Your profile will be upgraded as soon as we receive the money order. INSTANT MONEY ORDER BY FAX - Gently tape the money order below and fax the form & money order to:1-888-853-4278 to show proof of purchase. Or, you may scan it and email it to: email@westernmatch.com. (We will upgrade your membership as soon as we recieve proof of purchase). Next mail the original money order and form to: Western Match - P.O. Box 20054, Fountain Hills, AZ 85269-0054. Instant Money Order by Fax Terms of Use: You agree to send the original money order within 7 business days, or your gold membership will be suspended until we receive it. We will upgrade your membership as soon as we receive proof of purchase. Your Signature: _____________________________ Date: _______________
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