FAX ORDER FORM

INTELLIVISION PRODUCTIONS, INC.
1104 HIGHLAND AV SUITE L
MANHATTAN BEACH, CA 9266

TELEPHONE NUMBER:  (877) INTLVSN (310) 379-4109
FAX NUMBER:        (310) 374-8431

PLEASE PRINT THE FOLLOWING INFORMATION AND FAX THE FORM TO 
310-374-8431:

BILLING NAME:
BILLING ADDRESS:
CITY, STATE, ZIP CODE:
AREA CODE/TELEPHONE NUMBER:  

EMAIL ADDRESS:

CREDIT CARD TYPE (CIRCLE ONE):  VISA  MC   DISC   AMEX

CREDIT CARD NUMBER:  

EXPIRATION DATE (mm/yy):

===================================================================

SHIP TO NAME
SHIP TO ADDRESS:
CITY, STATE, ZIP:
AREA CODE/TELEPHONE NUMBER:

PLEASE FILL IN THE QUANTITY OF THE ITEM(S) YOU WISH TO ORDER:


____ITEM #10010 INTELLIVISION LIVES! (PC/MAC) @ 29.95/E
____ITEM #10020 INTELLIVISION ROCKS (PC/MAC) @ 29.95/E
____ITEM #75146 COLECOVISION HITS (WINDOWS) @ $29.95/E
____ITEM #40500 INTELLIVISION IN HI-FI MUSIC CD @14.95/E
____ITEM #40012 INTELLIVISION POSTER @9.95/E
____ITEM #40010 INTELLIVISION MUG @9.95/E
____ITEM #90001 INTELLIVISION BASEBALL CAP @14.95/E
____ITEM #94001 BLACK ASTROSMASH TEE (LARGE) @ $14.95/E
____ITEM #94003 BLACK ASTROSMASH TEE (X-LARGE) @ $14.95/E
____ITEM #94005 BLACK ASTROSMASH TEE (XX-LARGE) @ $14.95/E
____ITEM #94001 BLACK POLO SHIRT (LARGE) @ 29.95/E
____ITEM #94003 BLACK POLO SHIRT (X-LARGE) @ $29.95/E
____ITEM #94005 BLACK POLO SHIRT (XX-LARGE) @ $29.95/E
____ITEM #92001 BLACK TEE W/PURPLE RUNNING MAN (LARGE) @ $14.95/E
____ITEM #92003 BLACK TEE W/PURPLE RUNNING MAN (X-LARGE) @ $14.95/E
____ITEM #92005 BLACK TEE W/PURPLE RUNNING MAN (XX-LARGE) @ $14.95/E
____ITEM #99001 RUNNING MAN TEE (BLUE/LARGE) @ $14.95/E
____ITEM #99005 RUNNING MAN TEE (BLUE/X-LARGE) @ $14.95/E
____ITEM #99007 RUNNING MAN TEE (BLUE/XX-LARGE) @ $14.95/E

UPON RECEIPT OF THIS FORM, YOUR ORDER WILL BE PROCESSED AND YOU 
WILL BE SENT A COMPLETE INVOICE VIA EMAIL SHOWING POSTAGE & HANDLING
AND FINAL TOTAL.  IF YOU PREFER TO BE CONTACTED VIA TELEPHONE, PLEASE
INDICATE SO ON THIS FORM.