Order Information
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Funny collection: PipeFun and ColorFun (3010-9) Price/Unit Quantity Total
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                                                $19.90      ______ _____

TOTAL AMOUNT ($U.S.)		 	   		   _____________

Payment Information
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Payment:        __ MasterCard     __ VISA     __ AMEX     __ Discover

                __ Check       __ Money order       __ Purchase order

For credit card orders
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Expiration Date: month ________________ year (4 digits) ________________

                Signature : ___________________  Date: _________________