Mail - In Form Request for HollywoodHottys.com Video Products

Video Title(s):

 

_________________________________________

 
Amount: $
__________ (US)
Check Number:
__________
Check Date:
 __________
   
Billing Address
  
Name:
 _________________________________________
Address:
 _________________________________________
City, State Zip:
 _________________________________________
Phone:
 _________________________________________
Email:
 _________________________________________
 
Shipping Address
  
Name:
 _________________________________________
Address:
 _________________________________________
City, State Zip:
 _________________________________________
Phone:
 _________________________________________
Email:
 _________________________________________
   

Make Check Out to:

HH Media Group, Inc.

Mailing Address:

Hollywood Hotty’s
P.O. Box 13184
Bridgeport, CT 06673-3184
 

Ordering Directions:

1) Print out this form using your browsers print button.

2) Please fill out the request form and print clearly.

3) make check out to: HH Media Group, Inc.

4) mail the form and check to the address above.

Once received, the order will be processed and shipped in a timely manner.