DENNY-MILLER.COM PRINTABLE ORDER FORM MAIL TO: PRINT THIS ORDER FORM Denny Miller Store MAKE CHECK OR MONEY ORDER PAYABLE TO: 9612 Gavin Stone Avenue DENNY MILLER Las Vegas, NV 89145 THIS FORM FOR PRINTING ONLY PERSONAL INFO - SHIP TO: Name ___________________________________________________________________ Address ___________________________________________________________________ City ___________________________________________________________________ State ___________________________________________________________________ Zip ___________________________________________________________________ EMAIL ___________________________________________________________________ I WANT TO BUY: Black & White or Color Pictures are $20.00 each Shipping is $5.15 US Priority Mail for unlimited number of pictures If ordering both pictures and 1 book, shipping is $8.00 Book $25.00 plus $8.00 Book Canada and Outside the US $32.00 Shipping - Overseas $18.00 Cost per ITEM Quantity COST item Limited Edition, autographed DUCK SHANNON, rubber duck $10.00 Photo #1 - Diving Tarzan $20.00 Photo #2 - Tarzan and Chimp $20.00 Photo #3 - Tarzan Standing $20.00 Photo #4 - Tarzan & Chimp $20.00 Photo #5 - Wagon Train (Color) $20.00 Photo #6 - Wagon Train Group $20.00 Photo #7 - Wagon Train Denny w/Horse $20.00 Photo #8 - 3 Old Scouts $20.00 Photo #9 – Denny Miller, Robert Horton, Robert Fuller & Buck Taylor $20.00 Photo #10 – Buck and the Preacher $20.00 Photo #11 - The Party w/Peter Sellers $20.00 Photo #12 - The Party $20.00 Photo #13 - Dr. Quinn Medicine Woman $20.00 Photo #14 - Wonder Woman $20.00 Photo #15 - The Hulk $20.00 Photo #16 - The Hulk (Color) $20.00 Photo #17 - Gilligan's Island w/girls $20.00 Photo #18 - Gilligan's Island Gang $20.00 Photo #19 - Gilligan's Island Denny $20.00 Photo #20 - “Clancy” Young Maverick $20.00 Photo #21 – The Party $20.00 Photo #22 – Gilligan & Tarzan $20.00 Photo #23 - Wagontrain $20.00 Photo #24 – Wagontrain Duke & Charlie $20.00 Photo #25 – Wagontrain Duke, Charlie & The Major $20.00 Photo #26 – 5 Tarzans $20.00 Photo #27 – Tarzan & Chimp $20.00 Photo #28 - Tarzan $20.00 Photo #29 – Life of Riley $20.00 Photo #30 – Rockford Files $20.00 Photo #31 – Hawaii Five O $20.00 Book - "Didn't You Use To Be What's His Name" $25.00 Book - "TOXIC WAIST? Get To KNOW SWEAT!" $17.99 Book- “ME TARZAN…YOU TRAIN” $25.00 Subtotal Tax: (NV residents only) 7.75% Shipping TOTALS Please Print clearly who you would like the Autograph made to. If ordering more than one item and multiple autographs please make clear which picture goes to who (#?). If you wish to send your own photo to be autographed, there is a $15.00 per photo charge plus postage. AUTOGRAPH INFO - TO:_____________________________________________ AUTOGRAPH INFO - TO:_____________________________________________ AUTOGRAPH INFO - TO:_____________________________________________ AUTOGRAPH INFO - TO:_____________________________________________ AUTOGRAPH INFO - TO:_____________________________________________ AUTOGRAPH INFO - TO:_____________________________________________ AUTOGRAPH INFO - TO:_____________________________________________ Thank your for ordering Return to Denny Miller Website.