Order Form:for Check and Money Order Payment

You can print this form after you fill it out by selecting File/Print from your browser.

Mail this form along with your check or money order payment to:


2 75 Appian Way
Asheville, NC 28704
If paying by Credit Card, we will contact you for credit card information and how to pay us using PayPal.com
Make payments with PayPal - it's fast, free and secure!
Ship to:
Name:
Address:
City:
State: Zip Code:
Payment Info:
Credit Card Type:
Credit Card Number:
Expiration Date Month: Year:
Name of Cardholder:

Phone Number: (note: necessary for processing credit card)

Order Info:
Item Quantity
Description
Price Each
Total Price:

Shipping

Sales Tax, if applicable

Total

View our information page regarding gicle� limited edition prints and pricing structure.

Poster print size 16" x 20", $50 each, (* means not available in this size)
Poster print size 11" x 14", $30 each
Inkjet Print size 8 1/2" x 11", $10 each, or 5 for $40

Cards 8 1/2" x 5 1/2"
$2 each with envelope, set of 8 - $15

Discount available by request in any size for quantity order.

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SHIPPING AND HANDLING
print sizes: .........................8 1/2 x 11........11 x 14........16 x 20........Books
Within the U.S. ................ .$5................... .$6................$10.............$6
Outside the U.S.................$10...................$15..............$20............ $15
If you are not completely satisfied by your print, you may return it within 14 days (From the date of purchase) for a full refund. �
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Questions? Chain Reaction Studio/Gallery

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