ADZART ORDER FORM

ITEM CODE#	ITEM NAME	DESIGN PREFERENCE or CODE# (if different)	COLOR PREFERENCE or CODE# (if different)	SIZE	HOW MANY?	PRICE	TOTAL

TOTAL
FOR SHIPPED ORDERS: ADD $3.20 FOR THE 1st ITEM & $1 FOR EACH ADDITIONAL ITEM (add .50 if sox, bandannas, boxers, G-strings)

SEND CHECK OR MONEY-ORDER PAYABLE TO: ADAM MAIALE, 204 W. 13th AVE, NORTH WILDWOOD, NJ 08260

GRAND TOTAL

Name___________________________________________________________________________________________________________________________________________

Sreet Address ____________________________________________________________________________________________________________________________________

City_______________________________________________________________________________________State__________________Zip_____________________________

Phone #_________________________________________________________E-Mail__________________________________________________________________________

(NOTE: I only need Phone # to confirm order)             CHECK HERE (      ) TO BE INCLUDED ON MY E-MAILING LIST FOR UPDATES ON MY LATEST ART.

Please, fill in your mailing address.

First Name

Last Name

Street Address

Apt., Suite #, etc.

City , State

Zipcode

Phone Number ( )
(Note: I only need your phone # to contact you & confirm your order. I don't need it if you check your email regularly.)

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what do you want to give me?

about70$100million, six12

pick a #:1269007420say what?