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| List Art Pieces You Want to Purchase | Price | Qty | Total |
| Subtotal | |||
| (Please add 10% of subtotal for shipping) Shipping | |||
| Handling | $3.00 | ||
| Total | |||
| Shipping: Please
add $3.00 and 10% of your total order for Shipping |
| Make checks payable and mail to: Jan Ford 7386 Roxbury Ave Manassas, VA 20109-3038 |
Charge To: □ VISA □ MasterCard |
Acct. Name _______________________________________________________ Acct. Number______________________________________________________ Expiration date:_____________________ Telephone # ____________________ Shipping Address: Name____________________________________________ Street________________________________________ Apt./Unit/Suite________ City___________________________ State_____________ Zip____________ |