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PRINT AND FAX THIS ORDER FORM TO (985) 674-1899 (click on FILE in browsers toolbar, then PRINT)
PRINT AND MAIL TO ADDRESS ON BOTTOM OF PAGE (click on FILE in browsers toolbar, then PRINT)
PHONE YOUR ORDER TO (757) 575-2501
DVD VIDEO’S
(buy 4 pick TWO FREE)
---check or circle---shipping is included FREE---
$15 Muscle
Dave1 $15 Couple
Workout 1 $15 Jim Football 2
$15
Clash 2001 $15 Warehouse 6 $15 Washington 1 $15
Amateur 6
$15 Jim 1 $15
Jim 3 $15 Jim 4 $15
Jim 5 $15 Jim 6 $15
Jim 7
PHOTO CD’S
(buy 3 pick TWO FREE)
---check or circle---shipping is included FREE---
$5 15,000 Bear Photos $5
24,000 Nude Sportsmen $5 33,000 Fetish Men
$5 9,000 Amateur Men $5
8,220 Wet Men $5 13,531 Jim Photos $5
Couples Sex
$5 2,700 Dick Nasty $5
4,600 Florida Bears $5 1,218 Gary Photos$5
2,747 Irish Sean
$5 14,160 Keith pt 1 $5
10,977 Keith pt 2 $5 2,700 MD Jim $5
1,700 Scuba Dave
DVDs Total $___________ + CDs Total $___________ = Grand TOTAL $ ____________
BILLING INFORMATION
Name on Card __________________________________________________________
Card Billing Address_____________________________________________________
City______________________________ State_______ Zip ___________
Card # ______________________________________________________
EXP _______________ EMAIL ____________________________ (usps tracking # will be sent to this email, optional)
USPS Tracking Number will be sent to email listed above (optional)
CHECKS ARE ALSO ACCEPTED, make payable to Gary Couch
SHIPPING INFORMATION
(if same as billing leave blank)Name ______________________________________________________
Address_____________________________________________________
City______________________________ State_______ Zip ___________
MAIL WITH PAYMENT TO:
Gary Couch
3633 Monroe Street Mandeville LA 70448
if paying by check make payable to GARY COUCH