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Get A Printed Copy of This Website!

 Get a copy of this website, printed in full color, mailed right to your door!

Completely Unsecure Order Form


I accept all kinds of credit cards, cash, checks, food stamps, and the like.
I offer a 1/2 day money back return period and an extended six day warranty on all of my products.

Make Your Selection:

I would like Printed Website Copies - Item # 1 - USD9,999.95 each

Customer Information

First Name Last Name

Address - Line 1

Address - Line 2

City State Zip Code

Daytime Phone Evening Phone

Email Address Fax Number

Mother's Maiden Name Father's Maiden Name

 

Personal Information

Sex Yes No Sometimes Rarely Blue Moon

Height Weight IQ Shoe Size SS #

Religion National Decent Fav. Color

Own a Gun? Yes No What Kind? Named?

Pets Fav. Character on MWC Worst

Bust Cup (if applicable) Waist Hips Tongue Pointer Finger

 

Customer Questionnaire

Have you ever danced with the devil in the pale moonlight? Yes No

Have you ever been shot by a family member? Yes No

Have you ever been too drunk to fish? Yes No

Have you ever dressed in the clothing of the opposite gender? Yes No

Do you think that Elvis is alive? Yes No Uh, huh!

Do you think that the WWF is real? Yes No

Have you ever done the Macarena? Yes No

Have you been sexually abused by a member of the government? Yes Not Yet

Do you eat red meat? Yes No Eating Right Now

 

Shipping Information

Shipping Address - Line 1

Shipping Address - Line 2

City State Zip Code

How would you like your order shipped?

Would you like it in a box? Yes No

Packing Peanuts as well? Yes No

Would you like us to send a working version? Yes No

When should we send it out?

 

Billing Information

First Name Last

MasterCard
Visa
Discover
American Express
Cash
Personal Check
Public Check
IOU
Monopoly Money

Was your payment method stolen?Yes No

Card Number Exp Date

When should your card be billed?