BRUSH CREEK MEDIA
ORDER FORM

We can not process your order without
your signature at the end of this form.

FAX TO: (415) 552-3244
OR MAIL TO:

BRUSH CREEK MEDIA
2215-R MARKET STREET, PMB #148
SAN FRANCISCO, CA 94114

Have any questions? Feel free to call us on our voice line (800) 234-3877.

PLACE YOUR ORDER HERE
Please allow 2 weeks for delivery
Expedited service available. Please call (800) 234-3877 ext 1

Your Name

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Payment

Check or Money Order enclosed
(Do not send cash!)
Visa	MasterCard
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Signature
(Required on all orders.)

I am legally old enough to order and own these materials. My signature above affirms this statement, and if I am ordering by credit card, also authorizes the charge.

Subscriptions:

		US	Canada Mexico	Foreign
BEAR^Ž	6 issues 12 issues	$39.00 72.00	$48.00 89.00	$65.00 120.00
BEAR^Ž Buddy	12 issues plus 50-word ad (Ad must be typed or printed)	85.00	95.00	120.00
International Leatherman	6 issues 12 issues	39.00 72.00	48.00 89.00	65.00 120.00
Bunkhouse	4 issues 8 issues	26.00 48.00	32.00 59.00	45.00 80.00
FQ	4 issues 8 issues	26.00 48.00	32.00 59.00	45.00 80.00
					Subtotal:

Back Issues:

Issue Number	Magazine Name	Quantity	US Price	Foriegn Price





				Subtotal:

Special Publications:

Item Number	Description	Quantity	US Price	Foriegn Price





				Subtotal:

Videos:

Item Number	Magazine Name	Quantity	US/VHS Price	PAL Price





				Subtotal:

Merchandise:

Item Number	Description	Quantity	Size or Color	Price





				Subtotal:

*How to calculate shipping:**
*Inside US (based on amount of order):**
	$1.00	-	$100.00	shipping is:	$6.50
	$100.01	-	$200.00	shipping is:	$9.50
	$200.01	or	greater	shipping is:	$12.50
*Outside US (based on the number of items):**
	First item			shipping is:	$15.00
	Each additional item			shipping is:	$2.00

* Shipping is already included in the price for subscriptions, magazine issues, calendars and BEAR^Ž Classic collections. Do not include these items in your shipping calculation.


Total from above:
California residents add 8.50% sales tax:
Shipping (see left):
Total:

All models appearing in these magazines and videos are 18 years of age or older. Proofs of age and other records required by section 2257 of title 18, United States code, with respect to this magazine are kept by the custodian of records at the following location: Custodian of Records, Brush Creek Media, Inc., 367 Ninth St., San Francisco, CA 94103.

BRUSH CREEK MEDIA ORDER FORM