Order Form

No. Ordered	Size	B & W / Color	# Heads (Subjects)	Price



Name:			TOTAL: (10% off if pre-paid in full at time of order)	$
Address:			Postage/Insurance Fee:	$ 15
City:			TOTAL DUE:	$
State:		Zip:	Down Payment: (30% non-refundable) (10% off total if pre-paid in full at time of order)	$
Phone:		Work:
\|__\| Visa, \|__\| MasterCard		Exp Date:	I agree to pay on completion:	$
Credit Card #:			Signed:
Signature:			Date:
Print and Mail Form with remittance to: Elizabeth Hinshaw, P.O. Box 585, Ashland, OR 97520 or call 530-459-5908 to complete

For additional information about
Elizabeth's art please write or phone:
Elizabeth Hinshaw
P.O. Box 585
Ashland, OR 97520
530-459-5908