ORDER FORM
Please print this page, fill it
out, and send it with payment to the address below.
FREE
STICKERS & GOODIES WITH EVERY ORDER!
| PRODUCT |
SIZE
(circle one) |
QUANTITY |
PRICE |
TOTAL EACH |
| "Be My Ex-Girlfriend"
CD |
|
|
$6.00 |
|
| "Music to Strip By"
CD |
|
|
$5.00 |
|
| Evil Jake T-shirt (black) |
S / M / L / XL |
|
$7.00 |
|
Baby Doll T-shirt
w/ Evil Jake logo |
one size
(it stretches) |
|
$9.00 |
|
Baby Doll T-shirt
w/ album cover girl graphics |
one size
(it stretches) |
|
$9.00 |
|
| Baseball T-shirt |
M / L / XL |
|
$12.00 |
|
| Hooded Sweatshirt |
M / L / XL |
|
$20.00 |
|
| |
Shipping |
$2.00 |
| |
Total |
|
SHIPPING INFORMATION
NAME: _______________________________________
ADDRESS: ____________________________________
_____________________________________________
CITY:_________________________________________
STATE: ________________ ZIP CODE: ___________
PLEASE MAKE ALL CHECKS/MONEY-ORDERS
PAYABLE TO "MIKE JACOBS"
MAIL YOUR PAYMENT AND THIS FORM TO:
Mike Jacobs / Evil Jake Stuff
145 E 60 St., #5B
New York, NY 10022