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                         Use this form for ON-LINE CREDIT CARD ORDERS ONLY. 

INSTRUCTIONS: Type in the number of copies and subtotals for each of the CD  you wish to order. Shipping  for the CD included in the US($3.00)  priority mail. Overseas and Canadain CD orders send $26.95 for airmail ($5.00)postage included.  Shipping included in price of t-shirts. Cannibal Ferox LD includes shipping($10.00) priority mail.  Enter the final total in the "TOTAL AMOUNT" box. Then, fill out the name and address information as well as the credit card info. Double-check everything for accuracy and click the SEND ORDER button. This form is presently unsecure, if you do not feel comfortable using please call in your order.

Question about ordering videos Click here

ITEM Cost per Item Quantity Total Cost
$17.50
$17.50
$69.99
$35.00
Subtotal
   TAX: Califronia residents should also add 8.25% sales tax
TOTAL AMOUNT:
                           
          Name   
Street address   
 Address (cont.) 
            City 
  State/Province 
 Zip/Postal code 
         Country 
          E-mail 
     Credit card 
 Cardholder name 
     Card number 
 Expiration date 

 Yes, I am interested in subscribing to DEEP RED, please
    email more info.

             AGE STATEMENT: By submitting this credit card order,
 I am certifying that I am 18 years of age or older and that I live in an area 
which has no prohibition against the receiving of adult material in the mail.

Your merchandise will be shipped as quickly as possible.

If you have questions or suggestions, please e-mail us at bhmedia@pacbell.net

Check and Money Order made out to Blackest Heart Media can be sent to:
Blackest Heart Media
PO Box 3376
Antioch, CA 94531-3376

Fax orders to (510) 753-0169

Thanks for your order.

T-shirts one size fits all.

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Rare Videos The Beyond Comic Cannibal Ferox LD
DEEP RED MORE T-SHIRTS FULCI TRIBUTE
ZOMBIE CD SOUNDTRACKS BH MAGAZINE

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08/20/98 12:00 AM
1998 All Rights Reserved
An Internet Zombie Production