ORDER FORM

01.  HOW TO ORDER
Please complete this form, print it, and send it in along with a check, money order, or purchase order to:

JOSH SHIPP PRODUCTIONS
PO BOX 530
LOS GATOS CA 95031-0530
02.  YOUR INFO

03.  RATES
Item

Quantity

  Size  

Price USD

Total

 Straight Jacket DVD     $10
 Empower Films T-Shirt   $15
          
          
   Subtotal      
         
  Shipping     $2.50 per item
          
  GRAND TOTAL      


Please make payments payable to JOSH SHIPP PRODUCTIONS