CATEGORIES
If you are already registered, please LOGIN.

Please complete this form to register for our Auction. Once your registration is approved you will be able to bid in this Auction and all future Auctions thereafter. Thank you for registering and Welcome to Memory Lane, Inc.

User Name: *
Password (5 char. min.): *
Password Again (confirm): *
Your email: *
First Name: *
Last Name: *
Company Name:
Street Address 1: *
Street Address 2:
City: *
State: *
Zip: *
Country: *
Phone Number (day): *
example form: xxx-xxx-xxxx
Phone Number (evening):*
Fax Number:
Other Phone Number:
Tax ID (only if a CA business):

Please supply the Month and Day of your Birthday which we will ask when you login. This is for security reasons. *
Month:

Day:
 
How did you hear about us:*
Please provide two hobby references that we may contact.  If using eBay as reference, please provide your ebay ID and approximate number of positive feedbacks: *
     

Please enter your credit card information below.

Please Note: Credit card information is required as part of the bidder identity verification process. Your credit card will not be charged. Auction lots cannot be paid for by credit card. If you would prefer to not register with a credit card, please call the Memory Lane Inc. office and we can accept your registration application by phone.

     
Check here if same as billing.
Name On Credit Card: *  
Credit Card Number: *  
CVV2 Number: *    
Card Type: *  
Expiration Date: * /  
Billing Address: *  
Billing Address:  
City: *  
State: *  
Zip Code: *  
     
Check the box below next to I Agree to accept the
User Agreement and Terms and Conditions of Sale

I Agree    I Decline