ZEUS ORDER FORM

ZEUS STUDIOS, INC.
P.O. BOX 64250
LOS ANGELES, CA 90064
TOLL-FREE ORDER LINE: (800) 259-7386
FAX: (310) 474-9645

ZEUS ORDER FROM DONNIE RUSSO'S WEBSITE

PLEASE PRINT ADDRESS BELOW

NAME:_____________________________________________
ADDRESS:__________________________________________
CITY:_________________________ STATE:____ ZIP:_______
TELEPHONE #:___________________________ CUST ID# ___________

WE MUST HAVE YOUR SIGNATURE BEFORE WE CAN FILL YOUR ORDER
I HEARBY CERTIFY THAT I AM AT LEAST 21 YEARS OF AGE AND AM ORDERING THESE ITEMS FOR MY OWN PRIVATE INTERESTS AND WILL NOT USE THEM AGAINST ZEUS OR ANY OTHERS IN ANY MANNER. I HEARBY REQUEST ZEUS TO SEND ME BROCHURES AND CATALOGS IN WHICH I EXPRESS INTERESTS BY MY SIGNATURE.

_______________________________________________
Signature for Certification (Full Legal Signature, please)

ITEM#	TITLE	PRICE	FIRST CLASS SHIPPING & HANDLING
			US & CANADA	$4.00 FOR FIRST TAPE $3.00 EACH ADDITIONAL

			FOREIGN	$10.00 PER TAPE
			NTSC format only PAL format not available
			TOTAL AMOUNT OF ORDER
			8 1/4% TAX (CA ONLY)
			LESS CREDIT (IF ANY)
			NET AMOUNT OF ORDER
			ADD POSTAGE/HANDLING
TOTAL AMOUNT OF ORDER			TOTAL ENCLOSED
METHOD OF PAYMENT (Circle one) AMX VISA MC DINERS CLUB DISCOVER CARD CASH CHECK M.O.
CREDIT CARD NUMBER:		EXP. DATE:
SIGNATURE (required if using credit card)