NonSportSingles.com 6955 No. Durango Drive #1115 c/o Box #367 Las Vegas, NV 89149 [ ] Money Order / Cashiers Check [ ] Personal Check Item # Title Quantity Price$ --------------------------------------------------------------- 1 ) --------------------------------------------------------------- 2 ) --------------------------------------------------------------- 3 ) --------------------------------------------------------------- 4 ) --------------------------------------------------------------- 5 ) --------------------------------------------------------------- 6 ) --------------------------------------------------------------- 7 ) --------------------------------------------------------------- 8 ) --------------------------------------------------------------- Sub Total $ : --------------------------------------------------------------- NV Sales Tax = 7.75% : --------------------------------------------------------------- Shipping : --------------------------------------------------------------- Total $ : --------------------------------------------------------------- Shipping Address (Please print clearly) --------------------------- Name: --------------------------------------------------------------- Address: --------------------------------------------------------------- City: State: Zip: --------------------------------------------------------------- Email Address: --------------------------------------------------------------- Additional Notes: ---------------------------------------------------------------