Sexyoz Advert Form

Instructions
1) You can fill in this form online using your keyboard. Or if you prefer you can print this form out and fill it in by hand.

2) Print the form by clicking on the printer button.
 Print This Item

3) Post the form to the following address:

SEXYOZ
PO BOX 355
GLADESVILLE NSW 1675
AUSTRALIA
Along with payment (personal cheques may take up to 14 days to clear). Please ensure cheques, Australian money orders are payable to 'Mondo Xpress Pty Ltd'. The amount also must be in Australian dollars.
Your Details
First Name:
Last Name:
Address:
Suburb:
State:
Post Code:
Country:
Telephone No:
Mobile No:
E-Mail Address:
Website Address:
Your Personal Advert
Write your 40 word advert in this box. You can send a photo with your advert.

If sending a photo, please write on the back of the photo 'I certify this is a recent photo of myself, and I give permission for it to be published on www.sexyoz.com'. Then date and sign the photo with the words: 'I certify that I am over 18 years of age.

Signed.........................................................'
Payment Details

Payment Type: Card Type:
Card Number: Expiry Date:
Name On Card: Card Holders Signature:  
Amount: $ Date: