827 Hollywood Way #135 Burbank, CA 91505 |
NAME ________________________________________________ |
TITLE
DVD NUMBER (JMV...) DVD #2 _____________________________________/_______________ DVD #3 _____________________________________/_______________ |
| Shipping
Fee: Domestic USA $6.50 per order
Canada/Mexico $6.50 per order
Overseas $15.00 per order
CA Residents Add 9.00% sales tax TOTAL_________ |
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Checks payable to "Jewell Marceau". Charges appear on your statement as "Jewell Marceau".
Credit Cards will be charge immediately for video/DVD orders and all orders will be shipped the same day or
next business day if ordered on a weekend.
All images and content in the site are copyrighted and may not be redistributed
or used in
any way without the expressed written permission of Jewell Marceau.
I hereby certify that I am 18 years of
age or older and aware that you are sending sexually-oriented material
which is for my own
individual use and will not be resold, copied, or in any way distributed by me, including
to minors.
I further state and agree that this material complies with my local
community standards.
SIGNATURE___________________________________________
Date___________ (Required
for ALL orders)