Those in need of assistance must provide your real details:

     The full name (currently registered):

     Date of birth: day / month words / year

     Place of birth (town of birth as ceryfikacie):

     State / Province:

     State:

     Current place of residence:

     Email:

     Phone:

Payment can be made: 

     By my Web page "PAYMENT" link

     Direct bank account at Chase Bank

     Bank Money Order

     Wester Union

     Moneybookers.com

     PayPal.com

Payments can be made in advance but at least one treatment to the front.