HTTP://WWW.PLAYBOY.COM
T-SHIRT ORDERS MAIL-IN FORM

Ship to:

       First Name:    Last Name: 
  Street Address1: 
  Street Address2: 
             City:  State/Province: 
         Zip Code:  
	   E-mail: 

 Location (circle one):   Continental United States	Canada

Bill to:

(if different from above)
       First Name:    Last Name: 
 Street Address 1: 
 Street Address 2: 
             City:  State/Province: 
         Zip Code: 
           E-mail: 

  Location (circle one):   Continental United States	Canada

Ordering Information:

(Canada and all states except New York, Illinois, and California.
All amounts are U.S. dollars.) 

Size	      price/each    Quantity black	Quantity white	

Small:		$12.00                
Medium:		$12.00                
Large:		$12.00                
x-large:	$12.00                

Total Quantity Ordered:

Ordering Information:

(New York, Illinois, and California: includes sales tax) 
Size	      price/each    Quantity black	Quantity white

Small:		$13.00                
Medium:		$13.00                
Large:		$13.00                
x-large:	$13.00                

Total Quantity Ordered:

Shipping Charges:

 1 Shirt  = $3.50
 2 Shirts = $4.50
 3 Shirts = $5.50
 4 Shirts = $6.50
 
 etc.
Please Total Your Order: 
Total Charges:

Method of Payment

circle one:
Check/Money Order
Credit Card (fill in information below)
Card (circle one):
Visa
MasterCard
American Express
Discover

Card Holder: Card Number: Expiration Date:

Note: You must be 18 years of age or older to place an order using a credit card. On your next credit card statement, your charge will be identifed as Playboy - www.playboy.com.

Print and mail this form along with payment to:

Playboy Enterprises, Inc.
Attn: New Media
680 N. Lake Shore Drive
Chicago, IL 60611
Copyright © 1995 Playboy Enterprises Inc.