Please print this page and then fill it out and send it in with your payment to:

Please write O-Town Fan Club-New Registration on your envelope to assist us in sorting the mail. (one registration per person- no family or group registrations please)

Name_____________________________________
Address___________________________________
____________________________________
City______________________ State/Province______________________
Country___________________ Zip/Postal Code_____________________
Phone: Area Code (_____) (_____-__________)
Fax: Area Code (_____) (_____-__________)
E-mail address: ______________________@__________________________
Do you wish to be placed on the fan club member e-list? Yes______ No ______
Age______ Male______ or Female_________ Birthday? (month/day/year) _________
Do you wish to be included on the pen-pal list? Yes______ No_________

Please send in 1) a SASE (self-addressed stamped envelope-regular size with 34 cents postage) if you live in the US or 2 international mailing coupons if you’re a Canadian or International fan IF you are not able to provide us with an e-mail address, 2) this registration form and 3) payment

Cost for annual membership for The O-Town Official International Fan Club is:

$22.50 + $3.00 postage/handling = $25.50 US Funds (by check/money order or credit card) for US fans

$22.50 + $4.00 postage/handling = $26.50 US Funds (by international money order or credit card…no checks please) for Canadian fans

$22.50 + $9.00 postage/handling = $31.50 US Funds (by international money order or credit card…no checks please) for International fans

If you wish to pay for membership using your credit card please also fill out the following information. Note: Charges will appear on your credit card statement as O-Town Fan Club.

Card type? Visa______ Mastercard_______
Card Number:____________________________ Expiry date: (month/year) ________
Name and Address of card holder: (please print)
First name__________________ Last name_____________________
Address_________________________
_________________________
City____________________ State/Province___________________
Country__________________ Zip/Postal Code__________________
Phone number of card holder: Area code (____) (_____)-(__________)
E-mail of card holder_________________@___________________________
Authorizing signature of card holder__________________________________