 |
Thank you for your interest in placing an order with artGalore.ca. Please fill in the following form, print it, and fax or mail it to us at the contact info below. If you have any questions you can email us at orders@artgalore.ca or call us toll free at 1-800-691-3411. |
|
Postal Mail |
or
Fax to: 1-866-929-8677 Include your credit card number and signature for prompt delivery. |
|
| Date |
I
would like to pay using: (check one) |
|
| Name | Visa Mastercard AMEX | |
| Address |
Name on Card |
|
| City |
Credit Card # |
|
| Province/State | Expiry Date mm/yy | |
| Postal/Zip Code |
Signature ___________________________ |
|
| Ship to: (Same) |
Cheque/Money Order (Payable to "Shaw Enterprises Inc.") |
|
| Email Address | ||
| Telephone Number |
|
Name
of Item |
Code |
Quantity |
Price |
Size |
Total |
|
Example
- Mona Lisa |
LF70 |
1 |
30.00 |
32
x 24 in |
Sample
$30.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Add options (canvas/mount/framing) - For additional images, add
info to the back of this page. |
|||||
|
Image total (see online FAQ for promtional discounts) $
|
|
Free Shipping $
Sub-total $
GST/HST (5% most places, 13% ON, NL, NB, 15% NS, 12% BC, of subtotal) $ Total $ (GST # - 83310 8855) |