Chance4U ORDER FORM 

If you prefer to order using checks, international money orders or cash, you may insert it into usual letter with printed order form at once. In this case you must go to printable order form.

Order 1-5 addresses and pay only $6.00 for each. Order 6-15 addresses and pay only $5.00 for each. Order more 15 addresses and pay only $4.00 for each. If you want your order delvered by ordinaly mail, please, add $1.5 for s$h per order.

Pay method (write Yes/Y, if necessary)
- checks, money orders or cash:
- through webmoney:

Delivery method (write Yes/Y, if necessary)
- e-mail (free delivery):
- mail (please, add $1.5 for s$h per order):

Your Name:
Address:
City:
State:
Country:
Postal Code:
Phone:
Email address:
Date:

Please, send me addresses of the following ladies
(input women identifiers over gap or comma):


Total sum is $ ___________ (please, add $1.5 if you select mail delivery method) 

Thank you for your order!