PULPhanson SUBSCRIPTION FORM


NAME: ____________________________________________

ADDRESS: _________________________________________

CITY: _____________________________________________

STATE/PROVENCE: _________________________________

COUNTRY: _________________

ZIP: _________________

E-MAIL: _________________



PLEASE SIGN ME UP FOR: (check all that apply)


FULL SUBSCRIPTION: ($8.00, $12.00 international)

You will receive ALL FOUR issues of PULPhanson (The Girlfriend Issue, The HOSTAGE! Issue, The PULPfiction Issue, and Issue 4.). Issues will be sent as they're published.


INDIVIDUAL ISSUES: ($2.00 each issue, $3.00 international)
(click on issue number for a brief description/cover scan)

Issue #1:
The Girlfriend Issue (pub. 03.14.01) 		Issue #2:
The Hostage Issue (pub. 06.26.01) 		Issue #3:
The Fiction Issue (pub. date 10.22.01) 		Issue #4:
General Theme (tentative pub. date 04.20.02)


TOTAL: $_________

INSTRUCTIONS:
  1. Print out this form.
  2. Fill it out completely.
  3. Include the apropriate amount of funds in American currency only, please. (Make all checks payable to Amanda Dupuis.)
  4. Mail it to:
PULP HANSON
P.O. BOX 492
WILDER, VT
05088
(After you send us the completed form and the full cost of subscription, please send us an e-mail letting us know that you've done so.)