KMFMS Mail Order Form v1.15
Use only the latest version at http://www.kmfms.com/
----------------------------------------------------

Mail this order form along with a money order
(no checks please) payable to Timothy Macinta to:

                                 Timothy Macinta
                                 155 Warren St #1
                                 Arlington, MA   02474
                                 USA
Shipping name and address:       ___________________________
  (Address must be in            ___________________________
   the US or Canada)             ___________________________
                                 ___________________________
Daytime phone:      _____________________
Evening phone:      _____________________
Your email address: _____________________
 (Note:  your email address will only be used to contact you in
 the event that there is a problem processing your order.  It
 will not be released to any third parties or placed on any
 mailing lists.)


Product                                Quantity Price   Subtotal
-------------------------------------- -------- ------- --------
    KMFMS mousepad                     _______ X $ 9.99 ________
 XL KMFMS T-shirt                      _______ X $15.99 ________
  L KMFMS T-shirt                      _______ X $15.99 ________
XXL KMFMS T-shirt                      _______ X $18.99 ________
 XL KMFMS T-shirt/mousepad combo pack  _______ X $22.99 ________
  L KMFMS T-shirt/mousepad combo pack  _______ X $22.99 ________
XXL KMFMS T-shirt/mousepad combo pack  _______ X $25.99 ________
----------------------------------------------------------------
Subtotal                                                ________
Base Shipping                                           $   6.00
Per Item Shipping (See below)                           ________
Total                                                   ________


Per item shipping:  add $0.50 per T-shirt and $0.25 per mousepad
unless they are part of a combo pack in which case just add $0.50
for the combo pack.

Please allow 4-5 weeks for delivery.

KMFMS merchandise can also be ordered securely online at
http://www.kmfms.com/