Mow-Toi Order Form

MOW-TOI ORDER FORM Mow-Toi Order Form

Please read carefully.

This is a Secure Transaction using the latest in encryption technology. If, however, you have any doubts about sending sensitive private information over the Internet, you may print out this form and mail or fax it to us.

We will notify you by email what the total amount charged to your account will be after your order has been processed.

Quantity desired

Price -
$238.23 each
+
$217.35 ea. shipping & handling
+
$109.27 ea. account setup

+ 10% tax (for WA, FL, HI, & Canada only)

Would you like to try my specially prepared prepackaged "Rick's Dung" fertilizer?
$24.99/30 lb. bag for solid number of bags
$5.99/48 oz. for liquid number of bottles

We need the following information to ship your order: (complete all fields)

(cash and checks not accepted - MUST be credit card)
Credit Card:("Secure transaction") VISA MASTERCARD LOWES HOME DEPOT TEXACO MONTGOMERY WARD DISNEY DOLLARS BURGER KING TACO BELL

Credit Card number: Expiration: PIN number(very important!):

Name:

Address:

City: State: Zip Code:

Telephone: Cell phone:

We need the following information to properly process your order: (check all that apply)

Planet of origin: Star sign:

E-mail address: Telephone:

Sex:

Social Security Number:

Drivers License Number:

Mothers Maiden Name:

Fathers Maiden Name:
check here if same as mothers maiden name (you must be from the hills of Tennessee)

Pets Maiden Name:
check here if same as mothers maiden name (your dog is your sister/brother)

Spouses name: 2nd spouses name: 3rd spouses name:

Lovers name: 2nd Lovers name: 3rd Lovers name:

Spouses Shoe Size LEFT: Spouses Shoe Size RIGHT:

Lovers Shoe Size LEFT: Lovers Shoe Size RIGHT:

Spouses Underwear Size: Are they clean?: Yes No

Your Age:(check all that apply)
unborn
Child(0-9)
Stupid(10-17)
Know it all(18-25)
Normal(26-34)
Forgot it all(35-40)
Senior(41-45)
Altzheimers(46-49)
Dead(50+)

Your Annual Income:
Taxed(under $25,000/yr)
Over Taxed(over $25,000 but under $75,000/yr)
Under Taxed(over $75,000 but under $100 Million/yr)
Loopholes galore(over $100 Million/yr)

The following is optional, but it helps us know who you are, and how to better serve you.

Number of Children in household? (hope you put 'em to work using this machine)

Number of Children in Shed?

Number of Children that are yours?

What is your highest level of education?

What kind of home do you live in?
Do you your home?

How far is your home from a paved road:
1 mile
10 miles
Don't know

Total number of vehicles that you own:
Number of vehicles that still crank:
Number of vehicles in front yard:
Number of vehicles in back yard:
Number of vehicles on cement blocks:
Model and year of your pickup:

Why is water "wet"? (essay form)

Do you tend to leave the toilet seat up or down?

How often do you bath:
Weekly
Monthly
Annually
Not applicable

Tell me about your computer

How much memory?

Does it have stereo speakers? yes, its cool no, its a boring piece of junk

How big is your hard...uh...drive? 0-250 MB 251-850 MB 850 MB-7 GB 7.1 - 999 GB a terrabyte or above