| General Information | |||
Name |
_____________________________________________________ | ||
| Age |
_____________________________________________________ | ||
| Note: You must be 18 years or older to order Mango products | |||
| How did you learn about Mango Products? | |||
| _____________________________________________________ | |||
Mailing Address Information |
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Street |
_____________________________________________________ | ||
Apartment |
_____________________________________________________ | ||
City |
_____________________________________________________ | ||
State |
_____________________________________________________ | ||
Postal Code |
_____________________________________________________ | ||
Country |
_____________________________________________________ | ||
Email |
_____________________________________________________ | ||
MANGO |
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Color and Size (specify number) |
____ Pink | ____ 3 1/2 inch | ____ 5 1/2 inch |
| ____ Coffee | ____ 3 1/2 inch | ____ 5 1/2 inch | |
| ____ Chocolate | ____ 3 1/2 inch | ____ 5 1/2 inch | |
Please Specify |
____ standard latex or silicone tube | ||
| ____ extra long | |||
| VESTS | |||
Model (specify number) |
____ Air Vent (Pullover) Long Cut - White | ||
| ____ Air Vent (Zipper) Short Cut - Grey | |||
____ Lycra (Velcro) Long Cut - White |
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Size (required) view the sizing chart |
S M L XL XXL | ||
| MANGO HARNESS | |||
Color |
______ Tan ______ Brown | ||
Hip Size (required) _____________________ Please specify in. or cm. |
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PACKY |
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Color and Size
(specify number) |
______ Pink | ______ 3 1/2 inch | ______ 5 1/2 inch |
| ______ Coffee | ______ 3 1/2 inch | ______ 5 1/2 inch | |
| ______ Chocolate | ______ 3 1/2 inch | ______ 5 1/2 inch | |
CYBERSKIN COCK |
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Color and Style
(specify number) |
______ Caucasian | _____ plain | _____ with bump |
| ______ Brown | _____ plain | _____ with bump | |
Specify |
_____ circumcised | ||
| _____ uncircumcised | |||
CYBER HARNESS |
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Color (specify number) |
______ Tan ______ Brown | ||
| Hip Size (required) _____________________ Please specify in. or cm. |
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| METOMANGO | |||
Color and Size (specify number) |
____ Pink | ____ 3 1/2 inch | ____ 5 1/2 inch |
| ____ Coffee | ____ 3 1/2 inch | ____ 5 1/2 inch | |
| ____ Chocolate | ____ 3 1/2 inch | ____ 5 1/2 inch | |
Tube Type |
____ Embedded ____ Extended | ||
| MANGO ERECTION SYSTEM | |||
| Cyberskin sleeve ______ Caucasian ______ Brown Specify color |
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| Harness Specify color |
______ Tan ______ Brown | ||
| Hip Size (required) _____________________ Please specify in. or cm. |
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| PHALLOPLASTY ERECTION SYSTEM | |||
|
Cyberskin sleeve ______ Caucasian _____ 3 in. tip _____ 1 1/2 in. tip |
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| Elastic band | Penile length ________ circumference at widest point ________ (Please specify in. or cm.) |
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PLEASE SEND |
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Mango(s) |
_____ 3 1/2" @ $64.95 US each = |
____________________ | |
Mango(s) |
_____ 5 1/2" @ $69.95 US each = |
____________________ | |
Mango Harness(es) |
_____ @ $29.95 US each = |
____________________ | |
Air Vent (Pullover) Long Cut - White |
_____ @ $78.80 US each = |
____________________ | |
Air Vent (Zipper) Short Cut - Grey |
_____ @ $75.80 US each = |
____________________ | |
Lycra (Velcro) Long Cut - White |
_____ @ $87.90 US each = |
____________________ | |
Packy(s) |
_____ 3 1/2" @ $11.95 US each = |
____________________ | |
Packy(s) |
_____ 5 1/2" @ $16.95 US each = |
____________________ | |
Cyberskin Cock(s) |
_____ plain @ $49.95 US each = |
____________________ | |
Cyberskin Cock(s) |
_____ with bump @ $54.95 US each = |
____________________ | |
Cyber Harness(es) |
_____ @ 29.95 US each = |
____________________ | |
MetoMango(s) |
_____ 3 1/2" @ $64.95 US each = |
____________________ | |
MetoMango(s) |
_____ 5 1/2" @ $69.95 US each = |
____________________ | |
Mango Erection System |
_______@ $64.95 US each = |
____________________ | |
Phalloplasty Erection System |
_______ @ $44.95 US each = |
____________________ | |
| Subtotal | |||
| Subtotal = |
____________________ |
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| Shipping and handling within the US | |||
| 0 to $49.99 - $5.00 $50 to $99.99 - $6.00 $100 to $149.99-$8.00 $150 to $199.99-$10.00 $200 and over - contact us Shipping = |
____________________ |
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| Shipping and handling outside the US | |||
| 0 to $149.95 - $35.00 $150 to $250 - $50.00 Over $250 - contact us NO ORDERS IN EXCESS OF 5 ITEMS CAN BE SHIPPED INTERNATIONALLY! Shipping = |
____________________ |
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| Sales Tax (Rhode Island residents only) | |||
7% sales tax = |
____________________ | ||
| Grand Total | |||
| TOTAL |
____________________ | ||
| Mail to: Mango Products P.O. Box 5496 Wakefield, RI 02880 USA VISIT US ON THE WEB AT WWW.MANGOPRODUCTS.NET! |
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