MAIL ORDER
 "I, the undersigned, hereby certify that I am an adult, at least 18 years of age. I am aware that I am requesting products to which are of an adult nature containing content that is sexually-oriented and not suitable for persons under the age of 18 years."
 

 Name
 

 Street Address
 

 City
 

 State / County
 

 Zip / Post Code
 

 Country
 

 Email Address
 

 Signature & Date
 
Number DVD Title PAL NTSC Price Total
   Her Life as a Pet#2 - Petgirls DVD     €35.00 €
   Her Life as a Pet#4 - Petgirls DVD     €35.00 €
   Her Life as a Pet#5 - Petgirls DVD     €35.00 €
   Her Life as a Pet#6 - Petgirls DVD / Pre-order     €35.00 €
           
   Abuse - Yellowhore#1 DVD     €40.00 €
   Head - Yellowhore#2 DVD     €40.00 €
           
   Handjob Heaven - TigerrJuggs DVD / Pre-order     €35.00 €
   Tigerr Stuffed#1 - TigerrJuggs DVD / Pre-order     €35.00 €
   Tigerr Stuffed#2 - TigerrJuggs DVD / Pre-order     €35.00 €
           
   Tigerr Juggs - signed photo     €25.00 €
   Tigerr Juggs - used panties     €35.00 €
   Tigerr Juggs - lipsticked handkerchief     €30.00 €
   Tigerr Juggs - Lipstick Juggs Writing     €20.00 €
   Tigerr Juggs - Custom Ringtone/MP3     €30.00 €
   Tigerr Juggs - Custom signed Birthday Card     €25.00 €
   Tigerr Juggs - TShirt - S/M/L/XL     €30.00 €
   Tigerr Juggs - Custom 100 Pictures Photo Set     €130.00 €
   Tigerr Juggs - Custom 60mins DVD     €200.00 €
   Tigerr Juggs - Custom 30mins DVD     €150.00 €
           
 Subtotal     €
  Shipping and Handling (US Mail or Air Letter Post)     €5.50 €5.50
           
 Total Enclosed     €
 

Instructions:
Print out and send this completed form and payment to the address below.
If you cannot print this form out, you MUST write out:

"I, the undersigned, hereby certify that I am an adult, at least 18 years of age.
I am aware that I am requesting products to which are of an adult nature containing content that is sexually-oriented and not suitable for persons under the age of 18 years."

Also please remember to include your postal address!
Please understand that you send cash at your own risk - Euros and US Dollar and GB Pounds equivalents only! We cannot accept any other currency.
If you choose to make a cheque payment please add $12.50 handling fee to the total. Make cheques payable to 'BensonMedia Productions', we will not dispatch the order until the cheque has cleared payment.

Click here for current exchange rates

Send To:
Benson Media, Postbus 3557, 1001 AJ Amsterdam, The Netherlands

We will notify you via email once your order has been processed and dispatched.
Please use a valid email account written clearly so we will be able to confirm your order.

Need Help?
If you need any further assistance in filling out this form please email us at office@benson-media.com

Many thanks for your purchase!
 

 
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