RLP Mail Forwarding Application If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required TEXAS HOME BASE MAIL FORWARDING APPLICATION THE ROAD LIFE PROJECT MEMBER PRICING Mail Forwarding services do not include mail scanning. You will not receive a username and password with this service. To view our Mail Scanning application, click here. First Name * Last Name * Spouse's Name Children Name(s) Business Name Current Mailing Address * City * State AA AE AP Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Post Code Country * Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'Ivoire Croatia (Local Name: Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Timor-Leste (East Timor) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard And Mc Donald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic Of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Of Korea, Republic Of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts And Nevis Saint Lucia Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia, South Sandwich Islands South Sudan Spain Sri Lanka St. Helena St. Pierre And Miquelon Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe Email * Phone (domestic or international) * Notes (optional) Texas Home Base Contract I have opened, read and agree with the Texas Home Base contract above * Based on the Mail Forwarding Service plan that I have selected below, by digitally signing this contract I Authorize Texas Home Base Mail Forwarding to charge my credit card in the amount below. I also agree that Texas Home Base has permission to renew my postage account balance for $50 when it drops below $10 using the card submitted and renew my contract the month that it will expire. If I do not wish to renew my contract I will inform Texas Home Base before the contract expiration date. Your completion of this authorization helps us protect you, our valued client, from credit card fraud. Texas Home Base will keep all information entered strictly confidential. Select Your Mail Forwarding Service * Weekly Forwarding Annual Contract $160 + $50 Postage Account Weekly Forwarding 6 Month Contract $80 + $50 Postage Account Weekly Forwarding 3 Month Contract $65 + $50 Postage Account Twice A Month Forwarding Annual Contract $130 + $50 Postage Account Twice A Month Forwarding 6 month Contract $65 + $50 Postage Account Twice A Month Forwarding 3 month Contract $50 + $50 Postage Account Monthly Forwarding Annual Contract $110 + $50 Postage Account Monthly Forwarding 6 Month Contract $55 + $50 Postage Account Monthly Forwarding 3 Month Contract $40 + $50 Postage Account Total $USD I certify that I am a member of The Road Life Project. I understand that if I cancel my service with The Road Life Project or my account becomes delinquent I will no longer receive the discounted rate above * I have read and agree to the Texas Home Base contract * I give my permission to have my mail sent by USPS First Class Envelope with no tracking attached (optional) I authorize Texas Home Base and it's employees to sign for USPS Certified Mail on my behalf (optional) Forward Non-Profit (optional) Forward Magazines (optional) I understand that my Texas Home Base contract will not begin until I have submitted the USPS 1583 document along with the 2 IDs required by the USPS. * The term of this contract is based on the mail forwarding plan you have selected. Prices are subject to change without notice when contract expires. To complete the sign up process you must download PS Form 1583 and email this form with two forms of photo ID to Texas Home Base. By signing this contract I declare that I have read, understand, and agree to the complete contract. Digital Signature * Date (M-D-YR) *