B-Movie Message Board Supporting Member Order Form for March 2008 - March 2009 I wish to purchase the following membership (please circle your choice): Illudium ($12) Explodium ($25) Solarmanite ($50) Name: ___________________________________ Mailing Address: ________________________ ________________________________________ BMMB Screen name: _________________________ E-mail address where you may be contacted: ___________________________ _______________________________ By signing here, you affirm that you have read and agree to the Terms and Conditions found on this web page: http://www.badmoviezone.com/sponsor/terms.html Signature _______________________________ Please include your payment (personal checks are fine for U.S. account holders, otherwise cash or money order in U.S. funds please) with this form and send it to: Stomp Tokyo 3616 Far West Blvd #117-145 Austin TX 78731 Make checks out to Stomp Tokyo. Thank you!