hookups

FRONT PAGE, 2nd ROW
Rates $US: $179 for 2 weeks, $299 monthly auto-renew,
$350 for 1 month, $899 for 3 months, $1499 for 6 months

PURCHASE BY VISA OR MASTERCARD:

Ad Information

Stage name:

Web site url (f you have a site):

Tagline (3 - 4 words)

Text for ad (if you do not have a web site)

Row to be listed on:

Reciprocal url
(where our link is on your site - required):

Card Holder Information

Full Name

Address

Apt/Suite

City

Country

ZIP Code

Telephone

E-mail address

Credit Card Information

Amount:

CC Type:

Card Number:

Exp. Date:

Card Verification Number
(3 digit code on back of card):

Please note: the fees charged are approximate and will vary slightly depending on your bank's exchange rate.

Credit card transactions will appear on your bill as "PRIME IMAGE CORPORATION".
Ads are NOT refundable.