Please enter your Billing and Shipping information below and Print this page.
Due to credit card anti-fraud settings, only US residents can buy the video online at this time. 
If you live outside the United States and would like to buy either:
- video #1 (VHS NTSC or DVD format) 
or
- video #2 the newest DVD 

please follow the instructions below. All sales are final, replacement only

You can fill in this form in your browser and then PRINT it using the browser. 

Or you can print it and fill it in by hand. 

If you print by hand Please print clearly!!! 
If I can't read your handwriting, I will hold the order until you contact me


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Items Purchased

Please circle your selection if ordering only one video
Item ID
Product
Qty
Price
Total
VIDEO1  EliseErotic's Leg Dreams Video 1
VHS tape- NTSC Format		 1   $34.95  $34.95
VIDEO1  EliseErotic's Leg Dreams Video 1
 DVD Format		 1   $34.95  $34.95
         
         
VIDEO2  EliseErotic's newest DVD
 Video 2		 1   $34.95  $34.95
   
Add 8.25% Tax if shipped to California ($2.88)  

Shipping and Handling 

Inside U.S.A. 
Outside U.S.A  

  

........................$6.00
........................$8.00
Total Purchased     

 $
Payment Type (Circle one) Visa  MasterCard  AmericanExpress
CC Number   Enter 0-9 (NUMBERS) ONLY!
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I hereby authorize the above charges to my credit card by EliseOnline

Sign here:_______________________________________ Date:__________________
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Mail order form and payment to:
EliseOnline
PO 4271
Seminole, FL 33775