ORDER FORM

All credit card payments are made through our secure server, regardless of how they are received, so there is no advantage to faxing us your order.

Please complete the following form to place your order.

ORDER FORM

From this page you will be taken to a secure server for online processing of your transaction.
Select the item(s) below that you would like to order.

1 year Membership ($ 180.00):
10 Addresses ($ 50.00):
20 Addresses ($ 75.00):
Other services ($ 1.00), Quantity:

GENERAL BILLING INFORMATION

If we already have your billing information, fill in this form.
(Lost your Password? Enter your email address and press continue -- it will be emailed to you)

Email Address:

Password:

If you are new to our service
Please provide the following billing infomation for our internal records
([TAB] and [SHIFT+TAB] move the cursor in the form)

First Name:
Last Name:
Address:
City:
State:	Zip/Postcode: Outside the USA use NA for a state
Country:
Phone Number:
Your Email address must be your real Email as the information you order will be sent to it. You may change your Email address at any time.
E-Mail:
Please provide an alpha-numeric password. Use a combination of at least 6 letters and number with no spaces
Password:
Retype Password:

Alternative Payment Methods
The most convenient way for our clients to pay for the services they require is online by credit card through our secure payment facility. However we can also accept payment by other methods. Please see our alternative payment methods page for details. Once the payment has been completed, we can then issue the appropriate credit to your account. If you have access to a credit card, and can use this instead, the ordering process from Russian Girl Agency is completely automated and you can obtain address details immediately.

Age MIN

Age MAX

Russian Girls from City