Gay-Mart Logo

If not paying by Credit Card,
Mail Orders must be accompanied by
Check or Money Order.



Gay-MART Order Form

    To pay by Credit Card,
  1. Fill out the Credit Card Information section below and
  2. Either Fax your order toll-free (within Canada and the USA) to 1-800-419-3883
  3. Or Mail your order to the address at the bottom of the form.



Credit Cards Accepted In
Canada, USA & Worldwide

American Express Logo
Discover Logo 		Mastercard Logo
Visa Logo


****** ORDERED BY ******
****** SHIP TO ******
(if different from Ordered By)

NAME:
__________________________________________________
NAME:
__________________________________________________

STREET:
__________________________________________________
STREET:
__________________________________________________

CITY:
__________________________________________________
CITY:
__________________________________________________
STATE
/PROVINCE:
__________________________________________________ 		STATE
/PROVINCE:
__________________________________________________

COUNTRY
__________________________________________________
COUNTRY
__________________________________________________
POSTAL
CODE:
__________________________________________________ 		POSTAL
CODE:
__________________________________________________
VOICE
PHONE:
__________________________________________________ 		VOICE
PHONE:
__________________________________________________
EMAIL
ADDRESS:
__________________________________________________ 		EMAIL
ADDRESS:
__________________________________________________

****** MERCHANDISE ORDER ******

PRODUCT
NUMBER 		PRODUCT
NAME 		COLOR, SIZE,
OR STYLE 		HOW
MANY? 		PRODUCT
LINE TOTAL






























































PRODUCT
TOTAL:

****** SHIPPING & HANDLING CHARGES ******

IF YOUR PRODUCT TOTAL IS
LESS THAN $3.00 ......... ADD $3.00 75.00 TO $99.99......... ADD $9.00
$3.00 TO $15.00......... ADD $5.00 100.00 TO $199.99........ ADD $10.00
15.00 TO $24.99........ ADD $6.00 200.00 TO $499.99........ ADD $15.00 ------------> SHIPPING & HANDLING: _______________
25.00 TO $49.99........ ADD $7.00 500.00 TO $999.99........ ADD $20.00
$50.00 TO $74.99......... ADD $8.00 1000.00 OR MORE........ ADD $25.00

ORDER TOTAL: _______________

******CREDIT CARD INFORMATION (Complete only if paying by Credit Card)******

Card
Type:
_________________________ 		Card
Number:
_________________________ 		Card Expiry
(MM/YY):
____________
Cardholder
Name:
__________________________________________________ 		Card Holder
Signature:
_______________________________________________________
Please sign the following statement, if you are purchasing adult oriented merchandise:
I am of legal age in my jurisdiction and consent to the purchase of sexual toys and products:

Signature: ____________________________________    Date: ______________________

Mail your order to

Gay-MART Enterprises Incorporated
- or - GME (if you prefer to be discreet)
PO Box 294, Station A
Nanaimo, BC, Canada
V9R 5K9 		Contact us on-line

Gay-MART is located on the web at http://www.gaymart.com.

Find out How to Reach Us
if you have suggestions or questions. 		Telephone

Toll-Free Voice:1.877.GAYMART
Toll-Free Fax: 1.800.419.3883
Local Voice: 250.754.4221
Local Fax: 250.754.4950

Copyright © 1994 - 2008.  All shops and services presented exclusively by Gay-MART Enterprises Incorporated