WILDERNESS ART
MAIL TO: 8559W 2nd Street Manistique, MI 49854
CALL IN: (906) 341-5263
| DESCRIPTION | QUANTITY |
PRICE |
TOTAL |
| ____________________________________________ | ________ | ____________ | ______________ |
| ____________________________________________ | ________ | ____________ | ______________ |
| ____________________________________________ | ________ | ____________ | ______________ |
| ____________________________________________ | ________ | ____________ | ______________ |
| ____________________________________________ | ________ | ____________ | ______________ |
| ____________________________________________ | ________ | ____________ | ______________ |
| **FRAMED OR MATED PRINT......ADD $15.00 | Postage* | ______________ | |
| **PENCIL REMARQUE.....................ADD $150.00 | Special add one** | ______________ | |
| **COLOR REMARQUE.....................ADD $250.00 | MI sales tax *** | ______________ | |
| (ALL PRICES SUBJECT TO CHANGE WITHOUT NOTICE) | TOTAL | ______________ |
*Postage & Handling
*All orders shipping within the USA - add $10.00 for shipping/insurance
*Extra charges for multiple print orders
*All orders shipping outside of the USA - call or email for rates
***Michigan residents please add 6% sales tax.
| Name ___________________________________________________________________________ |
| Address: _________________________________________________________________________ |
| City, State, Zip: ____________________________________________________________________ |
| Phone: ___________________________ Email Address: ___________________________________ |
| ____ M.O. enclosed | ____ Check enclosed | _____ VISA | _____ MASTERCARD |
|
If charging on a credit card, all information below MUST be filled out. |
| Credit Card Number:_____________________________________ Expiration Date: ________________ |
| Card Holders Name: _____________________________ Signature: ____________________________ |
| Cards Billing Address: ________________________________________________________________ |
| Card Holders Home phone: __________________________ Work Phone: _______________________ |