Black Cat Cinema - VHS Order Form

Name

Address

City

State

Zip

Country

Print & Mail Form to:

M. DiPaolo/
Black Cat Cinema
PO Box 245
West Sand Lake, NY 12196

Make checks or money orders payable to: "M. DiPaolo"

For mature audiences.
I certify that I am over 18:

________________________

Terms

All values in US dollars. Include payment of check or money order
Make checks payable to "M. DiPaolo"

Description Quantity Amount

Daddy
82 minutes, Color, VHS NTSC

x $19.95

Transgression
83 minutes, Color, VHS NTSC (Directors Cut)

x $29.95

Requiem For A Whore
75 minutes, Black & White, VHS NTSC

x $19.95

Bought & Sold
76 minutes, Color, VHS NTSC

x $19.95

Brutal Ardor
48 minutes, Color, VHS NTSC

x $14.95

City of Sin
22 minutes, B&W & Color, VHS NTSC

x $14.95

Death Desire (Coming Soon)
83 minutes VHS NTSC

x $29.95

Shipping Rates

Subtotal

Sales Tax
(New York State Residents Only)
Add 8.25% Sales Tax

Shipping
(See chart at left)

Total