ORDER FORM
(please print and fill out completely)

Please send me the following movies (Canadian residents add 5% sales tax) (Quebec residents add 5% + 7.5% sales tax). By my signature below, I declare under penalty of perjury and affirm the following: I am at least 18 years of age, I am requesting your materials only for my own personal use in my private residence. I will not exhibit any material you send me to a minor and will carefully insure that no minor has access to it. I personally warrant that the materials I am requesting, to the best of my knowledge and belief, contain only descriptions or depictions of sexual activity which are acceptable for adults in my community, based upon the average adult person applying current community standards.

Signature ___________________________________________________________ Date ____________

Single DVDs are $30.00 USD each.
Order 4 DVDs and get the 5th one FREE.
Order 8 DVDs and get the 9th + 10th ones FREE.
Order 12 DVDs and get the 13th + 14th + 15th ones FREE.
ETC...

Shipping charges for dvds is in us funds: $6 for 1-2, $12 for 3-5, $16 for 6-9, $20 for 10-14, $25 for 15-19 and $30 for 20 or more. Non usa/canada orders, triple shipping. (Canadian residents add 5% sales tax) (Quebec residents add 5% + 7.5% sales tax)

We currently have Brutal Dildos Volume 1 through 37 on DVD, along with Moms Teaching Teens Volume 1 through 27. Order 4 DVDs and get the 5th one FREE.

DVD SELECTION

BD 1 __ BD 2 __ BD 3 __ BD 4 __ BD 5 __ BD 6 __ BD 7 __ BD 8 __ BD 9 __ BD 10 __

BD 11 __ BD 12 __ BD 13 __ BD 14 __ BD 15 __ BD 16 __ BD 17 __ BD 18 __ BD 19 __ BD 20 __

BD 21 __ BD 22 __ BD 23 __ BD 24 __ BD 25 __ BD 26 __ BD 27 __ BD 28 __ BD 29 __ BD 30 __

BD 31 __ BD 32 __ BD 33 __ BD 34 __ BD 35 __ BD 36 __ BD 37 __


MTT 1 __ MTT 2 __ MTT 3 __ MTT 4 __ MTT 5 __ MTT 6 __ MTT 7 __ MTT 8 __ MTT 9 __ MTT 10 __

MTT 11 __ MTT 12 __ MTT 13 __ MTT 14 __ MTT 15 __ MTT 16 __ MTT 17 __ MTT 18 __ MTT 19 __ MTT 20 __

MTT 21 __ MTT 22 __ MTT 23 __ MTT 24 __ MTT 25 __ MTT 26 __ MTT 27 __


Total DVDs at $30.00 each ___

Total DVD Cost $________
Total Shipping $___________.

Tax (5%, Canada/Quebec only) $_________

Tax (7.5%, Quebec only) $_________

TOTAL $__________

Please allow 1 to 2 weeks for delivery once order has been shipped.

Name_____________________________________________________________

Address____________________________________________________________

City/State/Zip________________________________________________________

Country________________________________________________________

E-Mail address _______________________________________________________


I am enclosing my payment in US DOLLARS by money order _____ cash _____

WE DO NOT TAKE POSTAL MONEY ORDERS...ONLY BANK MONEY ORDERS ARE ACCEPTED!

Mail Checks payable to:
Melting Images Inc.
CP 314, Succ Jean-Talon
Montreal, Quebec
H1S 2Z3
Canada

E-MAIL Steve: webmaster@brutaldildos.com. Visit BrutalDildos.com or MomsTeachingTeens.com

WE CANNOT SHIP TO PO BOXES- WE NEED A PHYSICAL STREET ADDRESS THAT IS DELIVERABLE.