Membership Checkout – staging.amourselect.com

A Payment Gateway must be set up before any payments will be processed.

Membership Information

You have selected the Standard (Bronze) membership level.

The price for membership is $0.00 now and then $19.99 per Month after your 7 day trial.

Username

Password

Confirm Password

Email Address

Confirm Email Address

Full Name LEAVE THIS BLANK

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First Name

Last Name

Address 1

Address 2

City

State

Postal Code

Country

Phone

Card Number

Expiration Date

Security Code (CVC)

A Payment Gateway must be set up before any payments will be processed.

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