DUNE TEMPORARY TATTOOS  -  www.customtattoos.net

1772 Farrell Ave., Clearwater, FL 33756       Ph: 1-877-679-9948      Fax:  1-727-230-8000

Name & Shipping Address:                                                Credit Card Name & Address If Different:

_____________________________                          _______________________________

_____________________________                          _______________________________

_____________________________                          _______________________________

Telephone/Email: __________________________________________________

Credit Card #  ______________________________  Exp. Date:  ________  CVV# ________

Please list product# and amount (e.g.  D511x6, BC547x10, etc.)  Shipping is 3-Day Priority or Overnight if requested.  $75 Minimum.  Use an additional page if necessary.  Please Fax large order.

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________