KMFMS Mail Order Form v1.15 Use only the latest version at http://www.kmfms.com/ ---------------------------------------------------- Mail this order form along with a money order (no checks please) payable to Timothy Macinta to: Timothy Macinta 155 Warren St #1 Arlington, MA 02474 USA Shipping name and address: ___________________________ (Address must be in ___________________________ the US or Canada) ___________________________ ___________________________ Daytime phone: _____________________ Evening phone: _____________________ Your email address: _____________________ (Note: your email address will only be used to contact you in the event that there is a problem processing your order. It will not be released to any third parties or placed on any mailing lists.) Product Quantity Price Subtotal -------------------------------------- -------- ------- -------- KMFMS mousepad _______ X $ 9.99 ________ XL KMFMS T-shirt _______ X $15.99 ________ L KMFMS T-shirt _______ X $15.99 ________ XXL KMFMS T-shirt _______ X $18.99 ________ XL KMFMS T-shirt/mousepad combo pack _______ X $22.99 ________ L KMFMS T-shirt/mousepad combo pack _______ X $22.99 ________ XXL KMFMS T-shirt/mousepad combo pack _______ X $25.99 ________ ---------------------------------------------------------------- Subtotal ________ Base Shipping $ 6.00 Per Item Shipping (See below) ________ Total ________ Per item shipping: add $0.50 per T-shirt and $0.25 per mousepad unless they are part of a combo pack in which case just add $0.50 for the combo pack. Please allow 4-5 weeks for delivery. KMFMS merchandise can also be ordered securely online at http://www.kmfms.com/