To Join INSTANTLY by check
just fill out the following form and click submit at the bottom of the form.

First Name

Last Name

Address

City

State

Zip

Phone

Email Address for the list

Please give us an optional email address so we can contact you if you loose your other address
We must have an email address to give you instructions and acknowledge your order.

Note the following...

The following fields are ALL REQUIRED!
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Account Holder's Name on the Check

Check Number (record this check as made out to Grizz's Safe Mail)

Name of Bank

City and State or Province where Bank is located

Pay to the order of

Ten and 0/100 Dollars

Fractional ABA number (for USA banks only - looks like 91-210/1225

9 digit Bank Routing or Transit Number (Canadians MUST put a hyphen in the 6th position - all funds are US Dollars)

Your Account Number (include spaces and hyphens)

Sign with Valid Email Address

I authorize Grizz's Safe Mail to use Checker 3.0 software to print a check on my bank for the above selected items in the amounts shown. I understand that the check will show up just like any other check on my monthly bank statement. YOUR ORDER WILL NOT BE PROCESSED IF THIS LITTLE BOX IS NOT CHECKED!

We must have your name and an email address to give you instructions and acknowledge your order.

(Please make sure the form is complete and accurate AND NOTE THAT THERE WILL BE A $20 CHARGE FOR CHECKS NOT HONORED!)