| First Name * |
|
Account Holders First Name
|
|
Last Name* |
|
Account Holders Last Name |
|
Middle Intial * |
|
Account Holders Middle Initial
|
|
Address 1 * |
|
A PO Box is acceptable
|
|
Address 2 |
|
|
Address 3
|
|
|
|
City * |
|
|
|
State * |
|
Abbreviations can be used
|
|
Zip Code * |
|
(10 digits or less)
|
|
Country * |
|
|
|
|
|
|
Shipping address
|
Same as above.
|
This address will be sent to the buyer of seller of auctions.
(if checked disreguard shipping address below)
|
|
Shipping Address 1 * |
|
A PO Box is acceptable
|
|
Shipping Address 2 |
|
|
Shipping Address 3
|
|
|
|
Shipping City * |
|
|
|
Shipping State * |
|
Abbreviations can be used
|
|
Shipping Zip Code * |
|
(10 digits or less)
|
|
Shipping Country * |
|
|
| |
|
|
| Telephone Numbers |
Telephone Number * |
|
area code + the number
|
|
Alt. Telephone Number |
|
Cell phone or other phone number
|
| |
|
|
| Birthdate |
|
Birthdate month - day - year mm-dd-yyyy * |
|
You must be at least 18 to register
|
| |
|
|
| Email |
|
Email Address * |
|
You will receive a confirmation at this email
|
Paypal Email Address
|
|
If you have a paypal account only
|