Bepassionate.com
Printable Order Form
The
following page can be printed and either faxed or mailed to Be Passionate
with your order. PO
Box 316, Woodbury, NY 11797. (516) 933-1069 Fax 1-866-336-1544
1-888-237-9350 Toll Free Order Line
Name:
E-mail:
Address:
Apt #:
City:
State:
Zip:
Country
Phone
#:
Qty
Item
#
Description
Color
Size
TOTAL
PRICE
Shipping
& Handling
$5.95
For orders under $50
$6.95 For orders $50 - $100
Free For orders over $100
International Order $20.00 1st Item
And $2.00 Each Additional Item
Item
Total
Postage
& Handling
Sub-Total
New
York State Residents add 8.75% sales tax
TOTAL
AMOUNT DUE
Payment
Type:
Visa
MasterCard
Check
Money Order
American Express
Discover
Credit
Card No.:
Exp.
Date:
Signature:
____________________________
Authorization:
In order to process your order, we need to have verification that you are
18 years of age or older and believe
that none of the material that you purchased is pornographic. You also believe
that all purchases are within the standards of your area and will not be
redistributed to minors and all products are sold for novelty use only.
I agree
to the above statement Signature:____________________________