*******************************ORDER FORM*******************************
Print it - Fill it out - Mail to address at bottom.
.
MY LIFE IN OUTER SPACE
JUST OUT! - © 2004


Price: $40.00
Please send me_____ @ $40.00 ea$__________* add $5.00 for outside USA
CA STATE TAX 8%$__________
U.S. POSTAGE
AND HANDLING		$______5.00 *
TOTAL ENCLOSED $__________

Items will be personally autographed if you wish. Please enter desired message: ______________________________________________________________

NAME________________________________________________________
ADDRESS _____________________________________________________
CITY ______________________________ STATE ______ ZIP ____________
PHONE (________) _____________________________


American Express or
Postal Money Orders Preferred
and clear immediately

Personal Checks take
10 days to clear.		 MAKE
PAYABLE
TO:

GLORIA PALL
SHOWGIRL PRESS
12814 VICTORY BLVD., #163
NO. HOLLYWOOD, CA 91606
FAX #: 818-509-0244


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