| PROPULSION MAIL ORDER FORM |
| Item/Description |
Quant. |
Price |
| Subtotal |
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| Sales Tax (NYS Res. add 8.65%) |
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| *Postage |
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| TOTAL |
| Print
it out, fill it out and send cash, check or money order payable to: |
| *POSTAGE: Air Mail. US/Mex/Can: $3 first item, $2 each add'l. |
| Other foreign terr: $5 first item, $4 each add'l. |
*Please write Jefe (at) testicle (dot) com, for exact postage rate, based on weight, delivery address
PURCHASER INFO:
| Name |
| Address |
| _________________________________________________________________________________ |
| City/State/Country/Zip Code |
| Phone (....... ...) |
| Please list alternates: |
| TEST PRESS & Mike Diana comix are for adults only. Please sign age statement: |
| By
my signature, I certify I am of legal age __________________________________________________________________ |
| This space is for your comments, ..Thanks for your support! Ya! |
|
__________________________________________________________________________________ |
Mail your order to: Jefe c/o Propulsion Productions - PO Box 1582 - Cooper Station - New York, NY 10276
any questions: email jefe (at) testicle (dot) com