Please fill out the following to complete your order:

Name:
Address:
Address:
City:
State:
Zipcode:
Country:
Email:
Phone:

Comments/Special Instructions:


Instructions:
Make your checks or money-order payable to Mr.INTERNET

then mail it together with this form to:

Mr.INTERNET
13162 Semora Pl.
CERRITOS, CA 90703, USA


SUBMIT Your valid "PayPal.com" @ [ PLZ NO password ]