Russian Women Marriage Agency Order Form

A Russian Women Marriage Agency order form

Would you like to order address of single woman?

You can pay with a credit card, check, cash, or money order.
You will select payment method later on this form.
We accept Visa, MasterCard, Discover, and American Express.

Please enter the reference number(s) of the ladie(s) you want to contact. One lady's reference per box only.

Press back or browse again if you forgot reference number.

The reference numbers are the 3, 4 or 5 digit / character combinations assigned to each lady. For example: 71570, C012 etc. DO NOT enter quotes, commas, pound signs ("#"), or their first names.

Please, pay attention to how you write reference numbers.

There are 2 types of reference numbers: the first one is with a letter before digits (for example V022) and the second one goes only with digits (for example 71828).

Need a help? Email us to or

Toll free phone: 1-866-Y-SINGLE (1-866-974-6453), Outside US call: 1-(407) 792-4615

Lady 1 #	Lady11#	Prices: 1-2 addresses - $14.00 each 3-5 addresses - $12.00 each 6-10 addresses - $10.00 each more than 10 addresses - $9.00 each
Lady 2 #	Lady12#
Lady 3 #	Lady13#
Lady 4 #	Lady14#
Lady 5 #	Lady15#
Lady 6 #	Lady16#
Lady 7 #	Lady17#
Lady 8 #	Lady18#
Lady 9 #	Lady19#
Lady10#	Lady20#

Shipping and payment information:

Select shipping option:		We don't charge for shipping if you choose email option. Yet you can have your order mailed to you at additional charge.
Your email address:		If you have chosen email for shipping, make sure you enter your email address correctly below:
Your name:
Address:
City:
State or province:
Zip or postal code:
Country:
Telephone:		This is optional, just so that we can contact you should there be any problem with your order
Select payment option:		Of credit cards, Visa, MC, Discover, and American Express are accepted
Credit Card number:		If you have chosen Check, Money Order, or Cash - leave blank
Expiration Date:	/	If you have chosen Check, Money Order, or Cash - leave blank
Your name exactly as it appears on the card:		If you have chosen Check, Money Order, or Cash - leave blank

Press this button to continue. You will have a chance to verify and confirmation all information. You will receive instructions on payment on the next screen.
Only after confirmation, your request will be completed.

Our services are strictly for persons 18 or more years old. By submitting the questionnaire and/or by using any of the services on our web site, you certify that you are 18 years of age, or older, and that you accept full responsibility for your actions.

Secure Credit Card Transaction Services provided by 1st International Marriage Network. See our Privacy Policy