HERE REGISTRATION FORM

The registration fee for Here is $10 US.  You may pay by
check or credit card.

Your Name:

______________________________________________________

Your Postal Address:

______________________________________________________

______________________________________________________

Your Email Address:

______________________________________________________

If paying by credit card:

Cardholder's Name:

______________________________________________________

Card's Issuer (check one):

___Visa ___Mastercard ___Discover

Card Number:

______________________________________________________

Card's Expiration Date:

______________________________________________________

Cardholder's Signature:

______________________________________________________

Please complete and mail this form, together with your check
or the above credit card information, to:

Everitt Beers
8928 Beverlywood Street
Los Angeles, California 90034-2418 USA

If paying by credit card, you can instead email this form to:

beers@cris.com

Thank you for your support!