PHOTODEX WALLPAPER ORDER FORM
	-----------------------------
	Photodex Corporation	800-377-4686 (ORDERS ONLY)
	1781 Barcelona Street	510-449-9079 Voice
	Livermore, CA  94550	510-449-3519 FAX

	CompuServe:	GO PHOTODEX [74774,3570]
	America Online:	Photodex
	Internet:	photodex@netcom.com

NAME:________________________________________________________________

ADDRESS:_____________________________________________________________

	_____________________________________________________________

CITY:_______________________ STATE:__________ ZIP:__________-________

PHONE:(______)_______-___________	 COUNTRY:____________________


Where did you hear about Photodex Wallpaper?_________________________

I would like order the following products from Photodex:
 __QTY__Description___________________________Price/Ea.______Price___

 ______ Tantalizing Textures (75 wallpapers)	$9.95	_____________

 ______ Patchwork Potpourri (165+ wallpapers)	$9.95	_____________

 ______ Wild & Crazy (125+ wallpapers)		$9.95	_____________

 ______ Beautiful Blondes (30 wallpapers)	$9.95	_____________

 ______ Beautiful Brunettes (30 wallpapers)	$9.95	_____________

 ______ Beautiful Brunettes II (30 wallpapers)	$9.95	_____________

 ______ ALL SIX (455 wallpaper images!)	       $39.95	_____________
					-----------------------------
					   SUB-TOTAL:  ______________
	
			  CA Res add 8.25% sales tax:  ______________

				 Shipping & Handling:  ______________
		     ($3.00 US/CANADA   $8.00 Foreign)

					       TOTAL:  ______________

Payment Method:	[ ] VISA	[ ] MasterCard		[ ] Check (US)
		[ ] AmEx	[ ] Discover		or Money Order
							   enclosed

Card Number:_________-_________-_________-_________  Expires:________

  Signature:_X____________________________________

   *** Fax, Mail, or E-Mail this form to Photodex (see above) ***