DIANNE KRUMEL ORDER REQUEST FORM

We gladly accept VISA, MASTER CARD, AMERICAN EXPRESS, Personal Checks, or Money Orders.
Upon receiving your order request we will call to confirm order and method of payment.
You can easily print and mail this form.

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Description

 

Size
Matted or Framed
 

Quantity

 

Price

 

Total
Sub Total: 
Florida Sales Tax (7.5%)
Shipping and Handling (See table below)
Total 



NAME:
ADDRESS:
CITY:
STATE/ PROV:
ZIP/ POST:
COUNTRY:
PHONE:
E-MAIL:


 

Shipping and Handling charges are as listed below

$0 - $100

$100 - $149

$150 - $249

$250 - $400

Over $400

$25.00

$40.00

$50.00

$75.00

Please Call