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..........._________________________________________