test Price: $0.50 First Name:* Last Name:* Address Line 1:* Address Line 2: City:* State/Province:* Zip/Postal Code:* Country:* Cell Phone: Home Phone: Address: City, State, Zip Code: PCF: Rate/Rank: Call Sign/Nickname: CosDiv: Email: Retired Military Username:* E-mail:* Password:* Password Confirmation:* Payment Method: Check PayPal Payment * Required field Jeremytest06.28.2014