Obtaining your MANcheck membership by Fax or Mail: 1 Fill in all applicable information 2 Print out this form 3 Make your certified cheque or money order in US FUNDS to: Diamont Canada, Inc. 4 Sign the bottom of the form 5 Mail it to: Diamont Canada, Inc. 2040 Berkshire Pl Nanimo, BC V9T 5R3 Canada or Fax it to 250-585-3276 With your credit card information. 6 18 YEARS of age is required for joining... Therefore proof of age required with certified cheque or money order. Make sure all fields are filled in. Without a complete address we can not authorize your application and without an email address we can not let you know your account is set up. Referral Number: 9999 Check-off the membership of your choice: I am applying for a regular MANcheck membership Upgrading my current membership 1 YR with 7 days of PLUS / $19.95 *Upgrade To MANcheckPlus Membership $39.95 2 YR with 7 days of PLUS / $29.95 *Upgrade To MANcheckPlus (fill in your id/password below) Login ID#: Password: Your information Card Holder's Name: Full E-Mail Address: Desired Password: Credit Card Number: CC Expiration Date: Card ID Number: On back of card,  last three digits Full Mailing Address: Card Holder's Signature: _____________________________________________ I authorize a credit card charge as indicated above for my membership to MANcheck. "Read our Terms and Conditions" The IP Address of the computer you are applying from is 38.107.179.237. Back to other ways to join