Purchase

Ordered by
Address
City/State/Zip
Ship To
Address
City/State/Zip
QUANTITY	ITEM DESCRIPTION	COST






	Sub-Total
	Michigan Residents Add 6% Sales Tax
	Shipping Charges*
	Total of Order
Indicate One	Check/Money Order enclosed (if mailing this form) Visa MasterCard (if Charging, fill in information below or call with number - I recommend that you call me with your charge card information. See phone number below.)
Make checks payable to Rod Lawrence
For Credit Card Orders: Card Number - - - Exp. Date CVV Number (if you do not know what this is go to this website for an explanation; http://en.wikipedia.org/wiki/Card_Security_Code Signature (if printing this form)__________________________________________*
**Shipping: $10.00 for each Print, $5.00 for each Plate, and $3.00 for Note Card Package(s)
**All Prints are shipped flat. For orders of Originals, or Bronze Sculptures, the actual shipping charges will be added to your invoice. If you prefer, for SECURITY reasons, you can send your order by mail (print this form), or order by telephone by calling my studio at 231-258-4724.

Name
E-mail
Tel
FAX

Ordered by

Address

City/State/Zip

Ship To

Address

City/State/Zip

QUANTITY

ITEM DESCRIPTION

COST

Sub-Total

Michigan Residents Add 6% Sales Tax

Shipping Charges*

Total of Order

Indicate One

Check/Money Order enclosed (if mailing this form)
Visa MasterCard (if Charging, fill in information below or call with number - I recommend that you call me with your charge card information. See phone number below.)

*For Credit Card Orders:

Card Number - - - Exp. Date

CVV Number (if you do not know what this is go to this website for an explanation; http://en.wikipedia.org/wiki/Card_Security_Code

**Shipping: $10.00 for each Print, $5.00 for each Plate, and $3.00 for Note Card Package(s)

**All Prints are shipped flat. For orders of Originals, or Bronze Sculptures, the actual shipping charges will be added to your invoice. If you prefer, for SECURITY reasons, you can send your order by mail (print this form), or order by telephone by calling my studio at 231-258-4724.

REQUIRED - Tell us how to get in touch with you:

Name

E-mail

Tel

FAX

Start Page

Rod Lawrence.
Copyright © 2007 [Rod Lawrence Paintings & Prints]. All rights reserved.
Revised: July 11, 2008 .

Purchase & Ordering Information

Order Form

Purchase & Ordering Information

Order Form

Ordered by

Address

City/State/Zip

Ship To

Address

City/State/Zip

QUANTITY

ITEM DESCRIPTION

COST

Sub-Total

Michigan Residents Add 6% Sales Tax

Shipping Charges*

Total of Order

Indicate One

Check/Money Order enclosed (if mailing this form) Visa MasterCard (if Charging, fill in information below or call with number - I recommend that you call me with your charge card information. See phone number below.)

*For Credit Card Orders:

Card Number - - - Exp. Date

CVV Number (if you do not know what this is go to this website for an explanation; http://en.wikipedia.org/wiki/Card_Security_Code

**Shipping: $10.00 for each Print, $5.00 for each Plate, and $3.00 for Note Card Package(s)

**All Prints are shipped flat. For orders of Originals, or Bronze Sculptures, the actual shipping charges will be added to your invoice. If you prefer, for SECURITY reasons, you can send your order by mail (print this form), or order by telephone by calling my studio at 231-258-4724.

REQUIRED - Tell us how to get in touch with you:

Name

E-mail

Tel

FAX

Start Page

Rod Lawrence. Copyright © 2007 [Rod Lawrence Paintings & Prints]. All rights reserved. Revised: July 11, 2008 .

Check/Money Order enclosed (if mailing this form)
Visa MasterCard (if Charging, fill in information below or call with number - I recommend that you call me with your charge card information. See phone number below.)

Rod Lawrence.
Copyright © 2007 [Rod Lawrence Paintings & Prints]. All rights reserved.
Revised: July 11, 2008 .