Order Form

Please reserve my "The Guiding Spirit"

Print(s) @ $40.00 = ____________________

Artist Proof(s) @ $125.00 = ____________

Shipping or shrink wrapping (if applicable) @ $5.00 = ____________

TOTAL ____________

Method of Payment

Money Order / cheque (payable to Donnybrook District Girlguides)

Name: __________________________________________________________

Address: _________________________________________________________

_________________________________________________________________

Postal Code: _______________Phone: __________________________________

Proceeds from the sale of these prints will be
used to purchase an equipment facility.

Mail Order Form To:

Jean Davis
122 Queen Street
Dorchester, Ontario
N0L 1G2