MAIL ORDER FORM

1. Print this order form and mail to us.
2. Mail to: High Drive Productions, 217 Thompson St, Ste 101, New York, NY 10012 USA

WARNING: WE WILL NOT BE ABLE TO SHIP YOUR ORDER WITH OUT THIS STATEMENT!

CUSTOMER RELEASE STATEMENT

I declare by signing this statement that I am 21 years of age or older. I also desire to receive sexually-oriented material for my personal use and authorize you to mail me such material. I have not requested the Postal Authorities or anyone else to protect me against the receipt of sexually-oriented materials. These materials will not be shown to minors and I believe they do not offend the standards of the community in which I live. I am not a Postal Inspector, a Law Enforcement Official or acting as an agent, attempting to obtain evidence for the prosecution of any individual or business. All of the above is understood and true.

PRINT THIS FORM & MAIL TO HIGH DRIVE

CUSTOMER INFORMATION
Department:
* Name:
* E-mail:
* Phone:
Address 1:
Address 2:
City:
State/Providence:
Zip/Postal Code:
TITLE & PRICE
Title 1
Title 2
Title 3
Title 4
Title 5:
Subtotal:
Tax: (NY State Residents add 8.875%)
Free Shipping
Total
PAYMENT INFORMATION (we accept check/money order & VISA/MASTERCARD)
VISA/MASTERCARD:
Expiry Date:
CCV: (3 digits above signature)
Prefer to mail us a check/money order?
SHIPPING INFORMATION (only if different from above address
Name:
Address 1:
Address 2:
City:
State/Providence:
ZIP/Postal Code:
Country:
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Message:
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GET IN TOUCH WITH US

E-MAIL:

sales@spunkstar.com

FAX:

(718) 403-0608

MAIL:

High Drive Productions,
217 Thompson St #101
New York, NY 10012

MAIL ORDER FORM

Print mail order form to pay by check or money order.

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