Mail in form for membership

Please complete the form below

First Name
Last Name

Please enter your e-mail address so we can confirm your membership and let you know what your user name is.
E-mail address

Please enter the user name you will need to log into the members' section. You will need to enter THREE possible choices for a user name. If someone is already using the first one, we will try your alternate choices. If all of your choices are taken, we will assign one for you as close to your choices as possible.
User Name:
Choice One
Choice Two
Choice Three

Now, please chose a password. Your password should be at least six characters. Passwords are case sensetive so 'MyPassworD' is different from 'mypassword', and please, don't use spaces in your password (i.e. 'my password').
Password

Last, please select the membership you wish to sign up for:
6 month membership $19.95 (USD)

Now, please print out this form and mail it to:
Brewer Twins LLC
PO Box 88
Hermosa Beach, California 90254
USA

With the form please include your Money Order or Cashier's Check (in US Dollars please) made payable to Brewer Twins LLC.

Thank you.