Order Form

                                                    Maxi Mounds Product Order Form

       ITEM                                                  PRICE                           TOTAL

#1. Autographed 8x10's (order by number) #_________           $10.00                                               _________

#2. 16 x 20 Color Poster                                                               $20.00                                               _________
(specify bikini or topless)

#3. T-Shirts (order by number) #_______ $20.00 _________

#4. Used Stockings $30.00 _________

#5. Used Panties $30.00 _________

#6. Used Bras $75.00 _________

#7. Mouse Pads (order by number)   #_______                         $12.00                                               _________

#8. Coolie Can Wraps (order by number)   #_______               $12.00                                               _________

#9. Score Magazines (month)_________________ $10.00 _________

#10. D-Cup November 2003 $10.00 _________

#11. Buxotica Magazine $10.00 ________

#12. The Maxi Mounds Guide To The World Of Exotic Dancing $17.95 ________

#13. Maxi Mounds Home Videos #1 DVD - $30.00 VHS - $15.00 _________

#14. Maxi Mounds Home Videos #2 DVD Only $30.00 _________

#15. Maxi Mounds Home Videos #3 DVD - $30.00 _________

#16. On Stage With Maxi Mounds! DVD Only $30.00 _________

#17. Score's Boob Cruise 2000 DVD - $30.00 VHS - $15.00 _________

#18. Napali's Max-Out! DVD - $20.00 VHS - $15.00 _________

#19. Score's Busty Auditions 2 VHS Only $15.00 _________

#20. Score's Mega Boob Olympics DVD - $30.00 VHS - $15.00 _________

#21. Phone Sex With Maxi Video DVD Only $30.00 _________

#22. Maxi In Bondage Video DVD - $30.00 _________

#23. Napali's Monumental Mams DVD - $20.00 VHS - $15.00 _________

#24. Napali's The Milking of Minka DVD - $20.00 VHS - $15.00 _________

#25. Maxi & Kayla's Big Boob Toy Story DVD - $35.00 VHS - $15.00 _________

#26. Maxi & Kayla's Big Boob Toy Story 2 DVD - $35.00 VHS - $15.00 ________

#27. Maxi Wet&Wild Video DVD - $30.00 VHS - $15.00 _________

#28. Maxi - Private Dancer Video DVD Only $25.00 _________

#29. Multi-O Maxi Video DVD - $25.00 VHS - $15.00 ________

#30. Maxi's Lingerie Show DVD - $30.00 ________

#31. Battle Of The Huge Ones DVD - $20.00 VHS - $15.00 ________

#32. Battle Of The Big Ones DVD Only $20.00 ________

#33. Score Classics #2 DVD Only $30.00 ________

#34. Maxi's Vegas Vacation DVD Only $30.00 ________

#35. Bound For Pleasure DVD Only $30.00 ________

#36. The Lost Score Video DVD Only $25.00 ________

#37. Bound For Pleasure 2 DVD Only $30.00 ________

#38. On The Road With Maxi DVD Only $30.00 ________

#39. Toy Time DVD Only $30.00 ________

#40. Bra Buster DVD Only $30.00 ________

#41. Missionary Impossible DVD Only $35.00 ________

#42. Hardcore Maxi DVD Only $30.00 ________

#43. Talkin' Dirty DVD Only $30.00 ________

#44. Teacher's Pet DVD Only $30.00 ________

#45. Hard At Work DVD Only $30.00 ________

#46. Just You & Me DVD Only $30.00 ________

#47. Bustin' Out! DVD Only $30.00 ________

#48. Stripper! DVD Only $30.00 ________

#49. Maxi's Fetish Fest DVD Only $40.00 ________

Please circle your choice of VHS or DVD if needed.
Underlined items are limited quantity and subject to availability

Subtotal: ___________

(Florida residents Must add 8% sales tax) ___________

Shipping Charge:
$6.00 for 1st item
$1.00 for each additional item ___________
Overseas orders add $5.00

Total Enclosed: ___________

If you'd prefer to pay by credit card please complete the following:
__MC __Visa __Discover __AMEX
Card Number:________________________________ Exp. Date:_________
Please provide Security Code (Last 3 Digits Above Signature):_________
American Express Cardholders enter the 4 digits above card number here:___________

Credit Card Orders Will Not Be Processed Without A Signature And Security Code
You must provide the exact credit card billing address in addition to the shipping address if the two are different.

Orders paid with credit card, cash or money order are shipped within 5 business days via Priority Mail if in the U.S.
If paying by personal check, please allow 2 weeks for your check to clear. Checks and Money orders should be made
payable to Mounds Productions. Personal clothing items may be delayed due to my touring schedule but will be
shipped as soon as possible.

Special Shipping, Autograph, or other instructions:_____________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

Ship To:
Name:_______________________________________________________
Address:_____________________________________________________
City:_________________________________________________________
State:________________________________________________________
Province/Country:______________________________________________
Zip Code:_____________________________________________________
Email Address (optional):________________________________________

Please sign the statement below or your order CANNOT be shipped.

I hereby certify that I am an adult of legal age to order adult entertainment products in the County, State,
and Country in which I reside. I also certify that I am ordering these products for my own use and will
NOT allow any minor to access them. I understand that unauthorized duplication of copyrighted materials is a violation of
Federal and International law. I further certify that I am not ordering these products for the purpose of entrapment or in the
course of any legal investigation or prosecution. I understand that all sales are final and Mounds Productions will not be
held liable for any customs seizures.

(Signed)______________________________________________________

Printed Name________________________________________________

Age________ Today's Date______________________

Send this completed form with your payment to:

Mounds Productions
P.O. Box 484
Englewood, Fla. 34295

Thanks for your order!