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BTF TECH PTY LTD
PO BOX 6397
POINT COOK
VIC 3030
AUSTRALIA

PRINTABLE POSTAL PAYMENT FORM
 Please complete this form then print, sign and send it to the mailing address shown above right.

Your Full Name:

Suggested Login:

(min 6 characters)

Suggested Password:

(min 6 characters)

Your Email Address:


New Member


Renewal

MEMBERSHIP TYPE
 * Prices are in (AUD). Check your local currency here


1 month
US $15


3 months
US $35


6 months
US $55

PAYMENT METHOD
 * Australian cheques only. Cheques must clear before membership is granted.
* Money orders received from outside Australia require an extra $5 for bank fees.


Credit Card


Money Order


Cash


Cheque

CREDIT CARD CUSTOMERS ONLY
 * The transaction will appear on your credit card statement as billed by BTF TECH PTY LTD.

Card Type:
 Expiry Date:
Please debit my card the equivalent of US $

CASH CUSTOMERS ONLY
* Wrap cash in this letter after printing. No Coins.

I enclose payment amount of $ for membership to Utopia-Web

YOU MUST SIGN THIS PAGE AFTER YOU PRINT IT
 *By signing this page you declare that you are of legal age to view adult
material and that you have read our membership terms and conditions .

Signed:...............................................Dated:.......................(dd/mm/yy)