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PRINT THIS PAGE AND USE IT AS YOUR
MAIL ORDER FORM FOR ALL GLASS SEX TOYS
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Shipping Charges (insurance included):
US "Lower 48" States Subtotal over $99: FREE SHIPPING!
US "Lower 48" States: UPS Ground..... $8.95
US "Lower 48" States: USPS Priority Mail..... $8.95
US "Lower 48" States: UPS Next Day Air..... $47.95
US "Lower 48" States: UPS 2nd Day Air..... $21.95
US "Lower 48" States: UPS 3 Day Select..... $17.95
AK, HI, Military, US Territories: USPS Priority Mail..... $10.95
Canada: UPS Standard..... $14.95
Canada: USPS Global Express..... $24.95
International: USPS Global Express..... $34.95
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Sales Tax 5.5% WI Only:
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Payment Method:
___Credit Card ___Money Order __Cashiers Check
**No Personal Checks**
Credit Card:
Credit Card Type: ___________________________________
CC number:____________________ Exp. Date:___________
Name on Card:______________________________________
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Send this gift to a friend:
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Make Money Orders or Cashiers Checks Payable to:
VANEVAN, INC. 1360 Regent St #231; Madison, WI 53715
PLEASE ALLOW 2-4 WEEKS FOR DELIVERY
IF YOU HAVE PURCHASED ADULT EROTICA:
THESE ITEMS ARE INTENDED FOR ADULTS
ONLY 18 YEARS OF AGE OR OLDER. BY SIGNING BELOW YOU ARE MAKING THE FOLLOWING
STATEMENT. I AM OVER 18 YRS OF AGE AND IT IS LEGAL FOR ME TO PURCHASE
ADULT EROTICA IN MY CITY, STATE, COUNTRY, TERRITORY OR PROVINCE.
I HAVE READ AND AGREE WITH ABOVE
STATEMENT
| SIGNATURE:
____________________________________ |
DATE OF BIRTH: ____________ |
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