TAPES OF TERROR VIDEO MAIL ORDER FORM

MAILING ADDRESS: Name _____________________________ Address ___________________________ ___________________________________ City _______________________________ State _____________________ Zip Code __________________ Phone # ___________________

CREDIT CARD INFORMATION: Account # __________________________ Exp. Date _________________ Visa ____ MC____ Amex____ Name on Card _______________________ Signature ___________________________ Email ______________________

TITLE	PRICE
SUBTOTAL
POSTAGE
3% VISA/MC OR 4.2% AMERICAN EXPRESS FEE
TOTAL ENCLOSED

Please make all orders payable to:

P. RIGGS, 11430 Mullins Drive, Dept. TOT, Houston, TX 77035-2632

Please sign that you are at least 18 years of age _________________________________