Step-By-Step Instructions to Reserve Standard Plan Room

Use this form to reserve a Standard Plan Room. Requests are considered tentative and not scheduled until payment has been received. We accept PayPal using your funds either  by balance, Mastercard, Visa, Discover, Payment accepted in U.S. funds only.
**This is a single room and may not be rented out to a 3rd party.

Please fill out completely. The information you provide will be used in setting up your room.

Your Name

Your Company

Your Title
Web Site

E-mail Address
Phone
Mailing Address
City, State, Zip
Location of TMC
Button on your site

 

Welcome Page Text:
        


Background Color (optional)

           
Blue Red LiteGrn Green Purple Pink

Welcome Color or Background * Main area is white
If using your own background please include URL to your background.
Bottom Info bar color


Additional Page Text: (we host - ie:   Hostess Opportunity)
        


Additional Page Text: (we host - ie:   Business Opportunity)
        

OR

Additional Pages: (you host)
1.     

2.     

3.     


Specials:
        

Drawings:
        

Information Request Form Boxes:
(ie:  Please add me to your mailing list.  Please send Hostess Info.  etc)
        
URL to Logo: 
Referring Client/Staff Member:
         
Set up fee- All new accounts are charged a 1 time set up fee of $15

If you have a discount code please place it here

Payment Section

Standard Plan:  $29.95  a year
Plus Set up fee to be included ($29.95 +$15 Set up fee= $44.95)


Amount Due Set up fee included ( $29.95 & $15 +$44.95)
I understand that I will receive a confirmation with total due including yearly room charge plus set up fee and that my reservation has been received and 
that upon payment of Set UP Fee of $15 that My room will be started.

Before the Chat is inserted to the room for one years rent with the room will be completed,
I agree to pay by PayPal subscription total of $29.95

  


All Year Rooms are on PayPal Sub Billing with total due including yearly room charge 
plus set up fee and that my reservation has been received and that upon payment for one years rent, the room will be completed.  
I will then be billed automatically ( receive PayPal payment request) on my billing date for one year rent unless I give at least five (5) days notice prior to my billing date of cancellation.
** Once payment is received there are no refunds**

Check method of payment:
PayPal.com Please provide your PayPal Account for us to send a payment request to:
Mail in Check or Money Order

Note: Be sure to submit THIS form at the bottom of the page. 

Pay by Mail-In

if you wish to mail in your check or money order, please fill out all the information on this form and click the Submit Form button ONCE. Print the resulting confirmation page TWICE so that you have a copy for your records and a copy to mail with your payment.
Make your check payable to Margaret Ross and mail to:


Peggy Ross ~ The Mouse Connection
5126 Karling Pl.
Palmdale CA 93552
(661) 533-0028

Returned checks will incur a $25 service fee

 

Yes, I have read all of the above and the FAQ's
Please initial agreement of terms including non rental to 3rd parties.
We will email you within 48 business hours to verify receipt of this form.

You will be taken to a confirmation page once you submit this form.
Print a copy of the confirmation page for your copy of this transaction.