Postal Mail Order Form

Anti-Bug Brew	Price	Amount	Total
	$6.00 per bottle	_____ bottles	________
	$30.00 per six-pack	_____ packs	________
	$28.00 per variety six-pack (one of each scent)	_____ packs	________
	Specify number of each scent:
	___ Citrus Explosion	___ Spice-O-Rama
	___ Woody Delight	___ Hippie Dreams
	___ Mint Overload	___ Vanilla Beanie

Triple-Threat	Price	Amount	Total
	$6.00 per bottle	_____ bottles	________
	$30.00 per six-pack	_____ packs	________
	$28.00 per variety six-pack (one of each scent)	_____ packs	________
	Specify number of each scent:
	___ Citrus Explosion	___ Spice-O-Rama
	___ Woody Delight	___ Hippie Dreams
	___ Mint Overload	___ Vanilla Beanie

Un-Stench	Price	Amount	Total
	$6.00 per bottle	_____ bottles	________
	$30.00 per six-pack	_____ packs	________
	$28.00 per variety six-pack (one of each scent)	_____ packs	________
	Specify number of each scent:
	___ Citrus Explosion	___ Spice-O-Rama
	___ Woody Delight	___ Hippie Dreams
	___ Mint Overload	___ Vanilla Beanie

Shipping	Price	Amount	Total
Priority mail:	$7.00 per six-pack or portion thereof	_____ packs	________
UPS Blue:	$12.00 per six-pack or portion thereof	_____ packs	________
UPS Red:	$20.00 per six-pack or portion thereof	_____ packs	________
Hand-delivered to people we know:	Free	Free	Free

			Total
Grand Total			________


Ship to	(street addresses only - no P.O. boxes please)
Name:
Address 1:
Address 2:
City:
State:
Zip code:
Telephone:
Email:
NOTE:	All information will be kept confidential.

Payments	Please send this order form along with a check or money order to:
	Mad Mike's
	96 Maine Street #133
	Brunswick, ME 04011

Comments	(please add any comments or special order requirements)

Orders ship within five business days of check clearance. Should inventory delays affect the shipping date, we'll notify you via telephone and/or email and give you a chance to change or cancel the order.

If you know us, feel free to give us a call and we'll let you know what's up.

Thank you for ordering. We'll do our best to get you a quality product as quickly as possible.