|
SHIP TO:
Name:_____________________________________________________________________
Street Address:___________________________________________________________
City, State, Zip Code and Country: _______________________________________
__________________________________________________________________________
Telephone Number:
Daytime (______)____________
Evenings(______)____________
PAYMENT METHOD:
Make checks and money orders payable to: "Phyllis Lawicki"
Check ________________
Money Order___________
QUANTITY. |
DOG PRINT TITLE |
PRICE EACH |
TOTAL |
| 1. | $ | ||
| 2. | $ | ||
| 3. | $ | ||
| 4. | $ | ||
| 5. | $ | ||
| Standard Prints | Please add $6.00 for flat shipping within the U.S. | $ | |
| Limited Edition Prints |
Please Add $8.50 for tube shipping within the U.S. | $ | |
| Limited Edition Prints | Please Add $11.00 for flat shipping within the U.S. | $ | |
| Ohio Residents Add 7% Sales Tax | |||
| Thank You | Total | $ |