Punished Brats
Mail Order Form
Please print neatly
Product __________________________________________ $ ____________
Product __________________________________________ $ ____________
Product __________________________________________ $ ____________
_______________Shipping ($4 within the US, $5 International) $ ____________
___________________________________.._________Total $ ____________
Format - Please circle one: ......... DVD ............. VHS
Payment - Please circle
one: ..... Check ......
Money Order
Make check or money order
out to PB Productions
Please note if paying via
check, order will not ship until payment has cleared
I hereby certify that I am at least 18 years of age.
SIGNATURE: _________________________________________
Send this order form to:
PB Productions
P.O. Box 413
Doylestown , PA 18901
Ship to:
Name.............._________________________________________
Address.........._________________________________________
City, State ......_________________________________________
Postal Code..._________________________________________
Country..........._________________________________________