BOUND HOTTIES

Mail in Order Form

Shattered Productions - PO BOX 114046 - North Providence, RI 02911
Make all checks or money orders payable to Shattered Productions

DISCLAIMER
By signing this form, I certify that I am at least 18 years old. I am aware that you are providing me with ADULT oriented material which is only for my use and will not be resold or in any way be redistributed.

PLEASE PRINT CLEARLY
 

PURCHASER:

   FIRST NAME _________________________________  LAST NAME____________________________________

   ADDRESS     _______________________________________________________________________________

  CITY ______________________________________________ STATE________________ ZIP______________

 E-MAIL    _________________________________________________________________________________

   SIGNATURE    ______________________________________________________________________________
(Required for Disclaimer. Without this we cannot process your order)

SUBSCRIPTIONS

____$14.99 for 1 Month of Access

 

____$38.99 for 3 Months of Access


____$59.99 for 6-Months of Access

 

____$24.99 Per Month of Access to Bound Hotties, Nylons Bound & Feet Exposed
 

PAYMENT METHOD - PLEASE CHECK ONE

    ______PERSONAL CHECK ENCLOSED

______MONEY ORDER ENCLOSED

______CASH  ENCLOSED

Your Username & Password will be emailed to you once your payment is received.

Please Print your email address clearly !!