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Order Surprise (Three- Pack) Passion Packets Here!

PRINT OUT THIS FORM AND MAIL TO:
A Night of Passion
P.O. Box 61431
Honolulu, Hi.96839

OR PRINT OUT THIS FORM AND FAX TO:
(808)-988-7435
PRICES INCLUDE SHIPPING AND HANDLING
Total number of Surprise Three - Packs Ordered @ $14.50 each_____
*International Orders add $4.50 per surprise 3-pack*
TOTAL $_______________
Ship to: (Please allow 6 to 10 days for shipping)
Name_________________________________________________ Address_______________________________________________
City __________________State________Zip Code____________
Country_____________
Telephone (____) ____________________
Payment: ____Check or Money Order (US Funds only) payable to: A Night of Passion
____JCB Card ____Visa ____Mastercard ____Discover ____American Express
Card # _____________________________________________________
Expiration Date _______________________________________________
Card Holder's Name____________________________________________

Card Holder's Signature__________________________________________