MACH 1 REGISTRY.COM Owner's Club
 SUPPORT FORM
 (Just print out, Fill in and mail with payment)
This helps maintain the website, upgrades and
Keeps the site mostly banner free of advertisers.

Make Checks/Money Orders
Payable to and send to:

Mailing Address:
David Wagner    
17 Orchard Street
Cuba, NY 14727
 
Website Donations

___ $ 5.00        ___ $10.00       ___ $15.00      ___ $20.00    

Other Amount $_____
     

Type of Payment:  ( ) U.S. Check  ( ) U.S. Money Order

Mailing Form:


Your Name: ________________________

Mailing Address: _____________________

City: ___________________  State: _____________  Zip:__________