Chatroom Registration Form

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I would like to register my Chat Username and Password. I have included my $20 cash payment for a 1 year membership.

This is a new registration

This is a renewal

Chatroom UserName_________________________

Chatroom Password _________________________

My Email Address _________________________

Your Comments:

Mail to:

P. A. International
558 Upper Gage Avenue, Suite 284
Hamilton, Ontario Canada
L8V 4J6