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CINEMA IMAGE PRODUCTIONS
12 Hempstead Avenue - Ste. 3G
Rockville Centre, NY 11570
(516) 297-2053
Fax (516) 485-9274
E-mail:
Scorpio20810@aol.com
Name_______________________________________
Address_____________________________________
City_________________________________ State__
Zip_______Country (if
outside US)
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TITLE
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QTY |
PRICE
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"AND THEN THEY WERE DEAD /
GUILTY PLEASURES (DVD)
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$9.99
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"PENNY
DREADFUL"
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$9.99
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"5 DEAD ON THE CRIMSON CANVAS"
(DVD) |
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$9.99 |
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"MACHINES OF LOVE AND HATE" (DVD) |
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$14.99 |
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BARRICADE (DVD) |
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$14.99 |
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"DARKNESS SURROUNDS ROBERTA" (DVD) |
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$14.99 |
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"DARKNESS SURROUNDS ROBERTA" (CD
SOUNDTRACK) |
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$15.99 |
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"FEARMAKERS" |
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$12.99 |
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"RED MIDNIGHT" (DVD) |
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$9.99 |
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SUB-TOTAL |
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POSTAGE
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TOTAL
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CREDIT CARD
ORDERS
__Visa __Mastercard __American Express
Card Number_________________________
Expiration ___________________________
Name on Card
Phone Number _______________________
E-mail Address_______________________
Postage is as follows:
US and Canada - $4.00 for
1 DVD, $1.00 each additional
European locations - $7.00
for 1 DVD, $1.00 each additional
Australia, Japan and all
other countries - $8.00 for 1 DVD, $1.00 each additional
Please make all checks or money orders payable to:
CINEMA IMAGE PRODUCTIONS,
12 Hempstead Avenue -
Ste. 3G
Rockville Centre, NY 11570
We accept VISA, MASTERCARD
and AMERICAN EXPRESS.
You can phone, fax, e-mail or mail in your order.
Please include type of credit card, card number, expiration date and name on
card.
If you're sending us an order by mail or fax, please print out this invoice and
send it with your payment.
Please note: Due to the violent and sexual subject matter of these
films, all buyers must be at least 18 years of age.
Buyer must include signature with order.
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