CultTVman Order Form


	Print this form, fill it out, and mail it with your payment to CultTVman PO Box 7041 Atlanta GA 30357-0041 YES! Please send me the following products

Item	Quantity	Price	Total







Subtotal


	NAME: ________________________________________ ADDRESS: _____________________________________ CITY _________________ STATE ______ZIP ________ COUNTRY ________________________ e-mail:______________________________________

Postage
6% Sales Tax (only Georgia residents)
Final Total

Payment information: check or money order accepted. Non US residents please use an international money order made out in US funds. Payment should be made out to CultTVman. Please allow up to 6 weeks of delivery. Personal checks may delay order while I wait for the check to clear the bank.

Postage: Please use the shopping cart to calculate actual postage.