ORDERING BY FAX

FAX ORDER FORM

Type in the information as needed in the spaces below. When you are done - hit PRINT on your computer and then just FAX the form to the number at the bottom of the page.

FAX LINES ARE OPEN 24 HOURS A DAY •• 7 DAYS PER WEEK

YOUR NAME
STREET ADDRESS
STREET ADDRESS continued
CITY
STATE
ZIP CODE
COUNTRY
YOUR E-MAIL ADDRESS
CREDIT CARD (choose one)	M/C VISA DISCOVER AMEX
CREDIT CARD NUMBER
EXP DATE
VIDEO(s) YOU WANT
TOTAL AMOUNT YOU OWE	$
IF YOU NEED A PAL FORMAT VIDEO - INDICATE HERE
ANY SPECIAL NOTES OR COMMENTS -TYPE HERE

READY TO ORDER? Be sure all your information is included & correct
NOW hit "PRINT" on your browser - and then FAX this form to:

(203) 849-1594
Your item usually ships withen 48 hours of receipt -THANK YOU for your business!
Questions - Just ask us here