Mail or Fax your Order

We have provided this Mail Order/Fax Form for your convenience. You may order any of our products directly through the mail or fax using various payment options listed below. Your order will be shipped immediately upon receiving your completed order. Just fill in the information below , print the form and mail or fax it to us.

EROTIC INTIMATES PO Box 8162 Manchester, CT 06042 Fax (860)645 7857
Your Billing/Mailing Address:
Name:
Street:
City, State, Zip:
Phone number (required Credit Card Orders):
Your e-mail address

Shipping Address (If different from Mailing Address):
Name:
Street:
City, State, Zip:

Items Ordered:
Item Number:	Item Description:	Quantity:	Item Price:	Total Price:











Subtotal:
Sales Tax (CT only), 6.00%:
Shipping Charge (from table):
Total:

Payment Options:
Credit Card, Check or Money Order.
Credit Card Customers please give the following info:
Type of Card:	Card Number	Expiration Date:	Name as it appears on the card:


Would you like to receive our monthly Newsletter and Product update email? Yes No We will never sell or otherwise distribute your email address. Your privacy is utmost to us.		Shipping Rates Table USA Priority with tracking.................$8.95 Express Mail USA...........................$21.95 Canada.........................................$16.95 International Ship Air....................$23.95