Order Form

Artwork (Order Form)

Please use an address that UPS will deliver to & obtain signature.

Name: _________________________________   Date: _________________

Address:________________________________________________________

City: ______________________________ State:_______  Zip: ___________

Phone:______________________________.     E-Mail:______________________________

• Please list artwork below: The price is listed per image on the image page..

            Print Name                                  Print Type *                              Amount           

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

• Print Type:  Regular Edition,   Artist Proof,   Remarqued Print

Personalization if applicable: ___________________________________________

________________________________________________________________________

1. Sub-Total ………………………………………………………………….$____________
2. Add Sales Tax   Price   +6%  (Pennsylvania Res only)…….$____________
3. Add Postage & Handling ($12.00 total order)………………..$____________
   • Total Price  (please add 1 + 2 + 3):                              $____________

Any extra instructions or comments: __________________________________________

_______________________________________________________________________________

• Enclose check, money order or fill out & sign for Mastercard or Visa orders.
  • MasterCard/Visa # _____________________________________
    • Expiration Date: ______________     Code: __________
    • Signature   ______________________________________
  • Make checks payable to Pine Ridge Productions, Inc.
• Allow 2-4 weeks for delivery. Delivery by UPS.

 Please print this order form, fill it out and mail it to:

• Pine Ridge Productions, Inc.
  1515 West Chester Pike    Unit A6
  West Chester, PA 19382    (610) 995-2047