Linda Draper |
| Customer: | __________________________________________________ | [VISA] [Master Card] |
| Address: | __________________________________________________ | #____________________ |
| City/St/Zip: | __________________________________________________ | Exp. date __________ |
| Email: | __________________________________________________ | Check # ___________ |
| Phone: | __________________________________________________ | Date:________Shipped:________ |
| Comments: |
| Subtotal: | |
| Virginia residents add 4.5% sales tax. Tax: | |
| Please call for a quote on shipping Postage: | |
| Make checks payable to: Eternal Moon TOTAL: | |
| I, the undersigned, agree to the terms as payment shown, and do hereby grant permission to Linda Draper/Eternal Moon to use my dog's image/portrait for advertising/displaypurposes. |
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| Signature: |
| Print only 15.5" x 29"...$100.00 Print, Double matted museum quality (acid free)22.5" x 35.5" ...$150.00 Print, Double Matted & Framed dark burl wood 25.5" x 38.5" ...$425.00 Custom pencil remarques, approx. 1.5" x 2", of your dog, from your photo, on the 2" lower border ...$50.00 Shipping/handling/insurance costs based on UPS zones from VA: Prints only ... $20.00 Matted prints ...$25.00 Framed prints ...$50.00 *All prices subject to change* Please print clearly and sign the form on the bottom left. |
