Note: If you are using a credit card, the address you use MUST be the same as the billing address for the credit card!! I DECLARE: That I am least 21 years of age. I desire to receive sexually oriented material for my own use and authorize you to mail me such material. I will not show material to minors. I believe that such material does not offend the standards of the community in which I live. I have not requested the Post Office Department or any one else to protect me against receipt of sexually oriented material. I am not a Postal Official or Law Enforcement Official or acting as an agent thereof, attempting to obtain evidence for the prosecution of any individual or business for the purpose of entrapment. All the above is understood and the information is true.

  First & Last Name      
  Email Address          
  Phone Number           
  Address                
  City                   
  State                  
  Zip Code               
  Country                

  Product(s) or Service  

  If we need to call you via telephone, when would be the best time to
  call? 

  Payment Method:
   Visa
   Mastercard
   Check

  Credit Card Number (If paying by CC) 
                       Expiration Date 

  Checking Acct Number,Check number and Transit Code (i.e. first row
  numbers on bottom left of check)