The Gabbo Network Store Mail Order Form -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- Name: _________________________________ Address: _________________________________ _________________________________ _________________________________ Email: _________________________________ -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- Payment by: __Check __Money Order __International Money Order -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- Product Price Each Qty Total --------------------------------------------------------------------- Purgatory / Paroxysm T-Shirt $16.00 x ___ $______ __M __L __XL __XXL __XXXL ytsejam@ax.com T-Shirt (discounted) $8.00 x ___ $______ XL Only Subtotal: $______ +--------------------+ | Shipping Rates: | | In US: $4.00 |------------> Shipping: $______ | Outside US: $9.00 | +--------------------+ Grand Total: $______ -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- Make the check, money order, or international money order for the Grand Total listed above payable to: Pat Griffin Send your payment to: The Gabbo Network Store c/o: Reality Squared Design P.O. Box 1042 Sterling Heights, MI 48311-1042