ONLINE ORDER FORM

Please print out this order form , fill in the banks and send it in with your check or money order.

item number (s) are  found on the top of each page. Phone orders : 213-471-2573

WHETHER ITS A  DVD, PHOTO CD,  MINI CD, CALENDAR, UNDERWEAR  OR ANY OTHER ITEMS ON THE TOP OF  EACH PAGE YOU WILL FIND THE ITEM NUMBER

Name__________________________________________________________

Address_________________________________________________________

City / State / Zip__________________________________________________

ITEM 1.________________ ITEM 2._________________

ITEM 3.________________ ITEM 4._________________

Any promotional code __________

ITEM 5.________________ ITEM 6._________________

ITEM 7.________________ ITEM 8._________________

MORE THEN  8 ITEMS CLICK HERE FOR OTHER FORM

Make Checks or money orders  payable to OMNI MEDIA

Send to:

OMNI MEDIA

P.O. BOX 56-5664

MIAMI ,  FLORIDA   33256

NOTICE: This offer is not available to person (s) under the age of 18.

PLEASE ALLOW 3 TO 4 DAYS FOR DELIVERY.