Very Private Mail Order Form

Billing Information	Shipping Information
Card Holder:	Name:
Address:                                                              #	Address                                                              #
City:                                              State:         Zip:	City:                                              State:         Zip:
Phone: (       )                           Fax: (        )	Phone: (       )                           Fax: (        )

Payment Method: Check: ___   Visa: ___    Master Card: ___    Money Order___

Card #: ________________________________ Expiration Date: ______

Check # ___________ Amount: $________    (Payable to Brandwynne Corp.)

Please enter the quantity and Total for the Items you wish to order.

Item	Description	Cost	Qty	Total
	Body Silk	$14.95	______	$__________
	pH balanced Body Wash	$14.95	______	$__________
	Intimate Moisture	$14.95	______	$__________
	Intimacy Kit = 3 Products save $10.00	$34.95	______	$__________
	Minimum shipping charge  (priority mail)	1-4	products	$4.60
	California residents please add  8.25% sales tax.	(Total x	.0825)	$__________
			Total	$__________

Please send and make check payable to: 

Brandwynne Corp. 
649 Stone Cyn. Rd. 
Los Angeles, CA  90077

Product ordering: (310) 471-7701

Fax Number (310) 472-1479

Please Email us for 5 or more products or overnight delivery.

Thank you for your trust.