ORDER FORM FOR GRACE GALLERY

First Name :
(required)

Last Name :
(required)


Full address:
including street,
city, state,
ZIP, country

if different from above
Shipping address:
including street,
city, state,
ZIP, country

E-mail :
(required)

Telephone :


Photographs ordered :
Catolog #
lg
sm
framed
unframed
quantity
price
  
 
 
 
 
 
 
 
 
   
packaging / handling charge
     E   1.50  
sub-total
(shipping charges to be added with confirmation)
 
Shipping Method
Method of Payment:
If you have choosen a credit card as form of payment please provide the following info.
Credit card :
Cardholder name:

Card #

Expiration date
on card :

NOTE: An exact shipping charge will be provided to customers along with an order
confirmation, prior to processing the order (shipping charges depend on the package weight,
delivery method chosen, and destination location).