Eclub International Corporation


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	Username
	Password

ECLUB International is committed to provide information the way you want it. To become a member please fill the following form:
Account Information

Username:
Begin with a letter, and use only letters (a-z), numbers (0-9), the underscore (_), and no spaces.
Password:
Must be at least eight (8) characters long, may contain numbers (0-9) and upper and lowercase letters (A-Z, a-z), but no spaces.Make sure it is difficult for others to guess!
Re-enter Password:
First Name:
Last Name:
Email:
Profile Information
Bank Name:
Bank Address:
City:
State/Province:
Country:
Zip/Postal Code:
Phone:
Fax:
Billing Information
One Month:		USD 39.99
Three Month:		USD 99.99 (SAVE USD 19.98)
Pay by Credit Card:
Credit Card Number:
Expiration Date:		- MM-YYYY
Pay by Check in Mail:
Notice: If you pay by Check in Mail your account will be activated after we receive your payment.