MAIL IN ORDER FORM

Buy 2 Penis Plugs/Get 1 FREE   |   FREE SHIPPING - When You Use Our Mail-in Order Form

ITEM NAME

ITEM SIZE

ITEM PRICE
1    
2    
3    
4    
5    
6    
SUBTOTAL           $
SHIPPING         $                          0.00
TOTAL PRICE           $

PLEASE PRINT OUT FORM - FILL IN THE BLANKS AND SEND TO:

A.B.T.        10 GRISHAM CIRCLE        BELLA VISTA, AR 72715

PLEASE MAKE PAYABLE TO:  PPAM

NAME:

PAYMENT TYPE (please circle payment type)
ADDRESS:

 

MONEY ORDER

CHECK
CITY:
STATE:
ZIP CODE:
PHONE NUMBER:
E-MAIL ADDRESS:
 

PLEASE ALLOW 10 DAYS FOR CHECKS TO CLEAR PRIOR TO SHIPPING

ALL PAYMENTS MUST BE IN US DOLLARS

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