Please fill out the information below.

First Name: *
Last Name: *
Address: *
City:	(Please indicate this information exactly as it appears in your mailing address.)
County, Territory or State
Postal Code:	(Please indicate this information exactly as it appears in your mailing address.)
Country: *
Your Age: *
Gender: *	Female   Male
Email Address: (optional)	(To be used if there are any questions and to confirm receipt of your registration. You do not need an e-mail address in order to register. The initial contact from your Pen Pal will be through the mail.)

If you would like to mail or fax the above information

Please send to:
Student Letter Exchange
211 Broadway, Ste 201
Lynbrook, NY 11563
USA

Please fax to: 516-887-8631

* required information

---

Web Weaver: VoyageurWeb