Your Full Name:
Email Address:

If you choose the Pay Option:

Send $3.00 with "PayPal":
To do so - fill out the two fields below and then click "Continue". You will then be taken to a PayPal payment page where you will be able to send us the $3.00 payment with either a credit card, checking account or your PayPal account. The PayPal account that your payment will be sent to is "paulrogerkinsella(AT)hotmail(D0T)com".

(After you make the payment, be sure to click on "Continue" at the bottom of the PayPal page. This will take you to the form you will need to fill out. If you forget to click "Continue", don't worry - we will send you an email, with a link to the form, within 48 hours of recivieing payment.
(If you have any questions, email us at paulrogerkinsella(AT)hotmail(D0T)com

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