ORDER FORM -- Erotic Certificates

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CERTIFICATES

Dick of Dickstinction Certificates:             How many? ___

  Made out to (names): _________________________

                       _________________________
                       

Bodacious Boobs Certificates:                   How many? ___

  Made out to (names): _________________________

                       _________________________


Lascivious Legs Certificates:                   How many? ___

  Made out to (names): _________________________

                       _________________________

TOTAL NUMBER OF CERTIFICATES:               Total number ____

Price: $12 each (special sale)                      x $ 12.00

TOTAL PRICE FOR CERTIFICATES:                            Total price: $ ________

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POSTAGE, HANDLING, AND GIFT TUBES

Gold gift tubes:
                            Each:  $2.95     How many? ___     Total: $ ________


Postage and Handling (PER MAILING TUBE, not per certificate):

        USA            Each tube:  $2.50     How many? ___
        Canada         Each tube:  $3.50     How many? ___     Total: $ ________
        Elsewhere      Each tube:  $6.50     How many? ___

If you want all your certificates mailed in the same tube, then enter "1" on the
appropriate line. (Most people will choose this option.) However, you may wish
certificates to be sent to different addresses. Likewise, each gold gift tube
must each be mailed in its own separate shipping tube.
         
GRAND TOTAL:                                             GRAND TOTAL: $ ________


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NAME AND SHIPPING ADDRESS FOR EACH MAILING TUBE:
         
_________________________  _________________________  _________________________

_________________________  _________________________  _________________________

_________________________  _________________________  _________________________

_________________________  _________________________  _________________________

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MAIL THIS FORM AND YOUR PAYMENT TO:

Jim W. / PhD Home Pages
PO Box 151365
San Diego CA 92175-1365
         
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FINALLY: Send me an e-mail so I'll visit my PO box promptly:

                           @phdtop.com
          ordercertificates
      
Be sure to use the word "NoSpamForJim" in your letter.
(This puts your e-mail into a non-spam, high-priority mailbox.)

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