LFP Registration Form

Secure Online Registration Form

Personal Information
IMPORTANT MEMBERS BILLING INFORMATION The following credit card companies; Visa, Diners Club, Mastercard, and American Express, are requiring that any charges made have current and accurate address information. This is for the protection of the cardholders, by cutting down on fraudulent use of credit cards. THE ADDRESS YOU HAVE LISTED MUST BE CORRECT OR YOU WILL NOT BE ABLE TO SUBSCRIBE. All new and renewing memberships are required to provide accurate credit card information. HOMETOWN BOYS does NOT give or sell members information to any organization. Your personal and credit card information is secured and confidential. Nothing is mailed to your address. Your correct address information is required solely to protect you and your credit card.
First Name:
Last Name:
Address:
City:
State:		Zip Code:
Country:		Phone:
Email Address:

Age:

What speed are you connected at:

Type of browser and version number:

Credit Card Information

Credit Card Type: Credit Card Number:

Expiration Date: (mm/yyyy)

Name on Card:

Billing Address:

Billing State: Billing Zip Code:

Please look over your information above carefully, and make sure it is correct before pressing the Register button below.

IMPORTANT NOTE:

Our Sites Require The Use of
Netscape 3.0 or Internet Explorer 3.0 Or Higher

Age:
What speed are you connected at:
Type of browser and version number:

Credit Card Information
Credit Card Type:		Credit Card Number:
		Expiration Date: (mm/yyyy)
Name on Card:
Billing Address:
Billing State:		Billing Zip Code: