MAIL ORDER VIDEO FORM

To order through the mail, print this form and send to: MIB POB 42430 Pittsburgh PA 15203 USA

To order over the phone call 412 362 6883 with your name, address, cc information and a list of titles.

I will receive an automatic notification that your order has been placed and will personally call you confirming such.

Please note that I will not call you back unless you are actually making an order.

To ask questions about DVDs, send email.

VIDEOS ARE FOR LEGAL ADULTS ONLY By signing this form I am stating that I am over 18 years of age and am aware that this is adult material with bondage and discipline themes. I am also aware of my local laws and am taking full responsibility and liability for contents. Signature:                                                                                           Date: I certify that I am over 18 years of age and am aware that this is adult material with bondage and discipline themes. I am aware of my local laws and am taking full responsibility and liability for contents DVDs are 4 for $100.00 all summer (includes shipping and handling) Please write the complete name(s) of the DVD(s) you would like to order here:         Name: Address: City, State, Zip: Country: Phone number: If this is a credit card order, enter the number _______    _______    _______    _______  exp. date _______   _______ security code on the back of your card:   If this is a check or money order, make it payable to MIB Productions.      Do not send cash.                                                         Mail to: MIB POB 42430 Pittsburgh PA 15203 USA                                                               DVDs are shipped in plain containers!

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