Please print this order form out & fill in your info & DVD selections. Prices for all DVDs is on each
individual page or take advantage of the bulk discount if ordering more than 1 DVD. Complete
your order by adding your selections up & including the shipping fees-which are-$6.50 for all US orders-no quantity limits, no matter how large the order-$15.00 for all foreign orders-also no limit on quantity! Personal checks take 2 weeks to process, money orders are shipped immediately, please do not send cash! Please, all foreign orders must be in US dollars. Yes, this order form can also be used for off line credit card ordering & also for membership into the Viper Pit .
Also, you can order by phone for credit card orders-call between 10:00 AM-6:00 PM eastern standard time-508-291-0792

First Name : Last Name :
Billing Address :
City : State   Zip :
Order
Videos
here

Video Selections

Shipping

Membership
Country :

The next 2 lines are for membership to the Viper Pit. Both your username & password MUST be at least  8 characters long & have both numbers & letters in them. We must have a valid email address to process your subscription

E-mail : Retype E-mail :

The next line is for membership to the Viper Pit. Both your username & password MUST be at least  8 characters long & have both numbers & letters in them

Username 
Password 

Birth Date : Month / Day / Year

Credit card information:

Card Number :
Type:
Expiration Date :
Month /
Year

All charges will appear on your cc as "Viper Visuals Ltd. 508-291-0792" 


    this form
If you are joining us by mail please be sure to send us the completed, printed form. If you are paying by check or money order please send us the completed, printed form along with your check or money order. Make checks/ money orders payable to: Viper Visuals Ltd.
Mail To: Viper Visuals Ltd.
16 Sconticut Neck Rd. #219
Fairhaven, Ma. 02719