To order: You may call us at 610-995-2047 or Print this form and fax it to 610-995-2059 or Print this form and send it to the address above.
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Ship to: Check here if same ___ If it is different please give detail below. | |||
Name:_______________________ Phone___________________ | |||
Address:___________________________________________ | |||
City:___________________ State_______ Zip___________ | |||
| We will ship USPS Priority Mail unless otherwise noted. | |||
| Quantity | Name of Print | Regular, Artist Proof, or Remarqued Print | Amount |
PA residents add 6% sales tax $ | |||
Shipping - $10 per order USPS Priority in the US Shipping $ | |||
Total $ | |||
| Any Special Instructions ? | |||
| Payment : ___ Check or Credit Card: ___ Visa ___ MasterCard ___ Discover ____ AMEX | |||
| Name (as on card): ______________________________ | |||
| Card Number: __________________________________ | |||
| Exp. Date: ___________ V-Code (Verification Code): __________ ? | |||
Signature :_________________________________ | |||
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All artwork on this web site has been copyrighted by the artist. All rights are reserved. You may not copy these images without the permission of the copyright holders. |
Presented by Pine Ridge Productions Inc. To order Click Here or call 610-995-2047 Any comments or questions on this site? Click Here This web site was produced and is maintained by Pine Ridge Productions Inc. Copyright 2000-2012 © Pine Ridge Productions Inc. All rights reserved. |
