Pornotopia.com's Mail-Order Form
1) Fill out this form Completely. 2) Print it and Sign it.
3) Please, Send U.S. Dollar Money Order (No personal checks) to:

SYZYGY ART, INC.
444 NE Winchester, PMB 10C
Roseburg, OR 97470
U.S.A.

Full Name:
Email Contact:
Your email is never sold, distributed or used for uninvited purposes.
It is only used to confirm memberships, shipped orders and for support.
Questions? Contact us: support@pornotopia.com

$20 : Membership Pass for 30 Days Access.
Username: 6 to 10 letters and numbers.
Password: 6 to 10 letters and numbers.

FREE shipping and handling.

$15 : Hardrotica II on CD-ROM
$25 : PornoMation on DVD
$25 : PornoMation 2 on DVD
$15 : PornoMation 3 on DVD

Discount Combination Package:

TOTAL: $ enclosed.
Ship to:
Mailing Address:
Address:
City:
State/Country:
Zip Code:

I am a legal adult. I will not hold Pornotopia.com and/or its associates liable
for unlawful purchases by minors. I agree to all terms and conditions.

____________________________________
Signature/Date Note: Unsigned orders will be returned.