--- please PRINT your answers ---
I am paying (select either 3 months or a year): _______ $39.95 USD membership for three months _______ $69.99 USD membership for a year What is your first and last name? Name: ____________________________________________________ What is your email address? Email: ____________________________________________________ What username would you like? (This could be the first part of your email address, for example.) Username: _______________________________________________ What country do you live in? _________________________________________ Please select one of the following as your security question (in case you forget your password): 1 What is your mother's maiden name? 2 What is your favorite pet's name? 3 What is your favorite movie? 4 What city was your father born in? 5 What city was your mother born in? 6 What is your father's middle name? 7 What is your mother's middle name? I want question #_______ as my security question. What is your answer to the question you chose? (Hint: keep it simple so you can remember it, but not obvious so someone can guess it.) Answer: ___________________________________________________