Mail order
subscription form for DVD orders - check
(10 business days to clear),
money order, cash or credit card
Print this form and fill it out completely.
Mail to: MIB
POB 42430 Pittsburgh PA 15203 USA
Your credit card charge will appear "MIB
Productions"
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Full name:
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Address:
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City, State,
Country, Postal code:
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Email address
if applicable:
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Phone
number:
I may need to call you to
ensure that your card is not being used fraudulently (make sure that
you are the card holder), so make sure this is a number you can receive
calls at.
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DVDS
FOR VIEWING BY LEGAL ADULTS ONLY
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I am over 18 years of age.
This
is adult material with bondage and discipline themes. I am aware of my local laws and am taking full liability for
website contents.
Signature:
Date:
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DVDs
Available By Mail:
Payment method: Check ,
Money Order or
CC _____ _____ _____
_____ exp. date:_____ _____
The 3 security code on the back of your
credit card:_________
The address
for your credit card:
List the titles
you would like to receive
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Mail to: MIB POB 42430 Pittsburgh PA 15203 USA
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Mail order subscription form for site membership - 1 year for 249.99
Print this form and fill it out completely.
Mail to: MIB
POB 42430 Pittsburgh PA 15203 USA
I will
be determining your username and password, and emailing you log in instructions.
Your credit card charge of 249.99 will appear "MIB
Productions"
|
Full name:
|
|
Address:
|
|
City, State,
Country, Postal code:
|
|
Email address
if applicable:
|
|
Phone
number:
I may need to call you to
ensure that your card is not being used fraudulently (make sure that
you are the card holder), so make sure this is a number you can receive
calls at.
|
|
WEBSITE IS FOR
VIEWING BY LEGAL ADULTS ONLY
|
|
I am over 18 years of age.
This
is adult material with bondage and discipline themes. I am aware of my local laws and am taking full liability for
website contents.
Signature:
Date:
|
|
Subscriptions
Available By Mail:
Payment method: Check ,
Money Order or
CC _____ _____ _____
_____ exp. date:_____ _____
The 3 security code on the back of your
credit card:_________
The address
for your credit card:
You will also be receiving 30 minutes of free VOD access
to another Irene Boss site.
Your login instructions will be emailed or mailed to
you.
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Mail to: MIB POB 42430 Pittsburgh PA 15203 USA
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