REMEMBER: Complete the BILLING ADDRESS up top(name, address, etc.) for the CREDIT CARD you use. We'll assume the MPD membership is for you UNLESS... You're paying for someone else and then also fill out the SHIPPING ADDRESS with their information.

Product Quantity Price Amount
One year individual membership in MPD Delete59.00 59.00

All prices are in US Dollars TOTAL 59.00

Who originally referred you? --- Renewal? Account number if you know it.

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