Register By Mail Please print this form and send it with your payment: Email Address ____________________________________ Make sure your e-mail address is accurate so we can send your login information. First and Last Name___________________________________ Prefered Username __________________ Prefered Password __________________ 3 Months of Access - $29.95 __________ 6 Months of Access - $59.95 __________ Your payment MUST be made in US FUNDS ONLY by check or money order. No cash. Your check or Money Order should be payable to BVCI MEDIA LLC and addressed to...... BVCI MEDIA LLC 226 N NOVA ROAD #106 ORMOND BEACH, FL 32174