Heath Studio - Order Form

JAN HEATH

ORIGINAL PRINTS
250 Quail Run Lane • BERKELEY SPRINGS, WV 25411

To place phone orders please call: 304.258.2482 OR 304.258.9840 
   
      
         ORDER
         FORM
                 Print out
         the form below, fill out, then mail to the address above.
         For wholesale information, please call.
         
         PAYMENT:  

                     BY CHECK -- Payable to Jan
                  Heath.

                     BY VISA, MASTERCARD, AMERICAN
                  EXPRESS DISCOVER

                     Please include full name,card
                  no., exp. date, and sign.
     
   































 
   
      
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Name:

Date:

Address:

City, State, ZIP:

Phone:

Credit Card:

__ Visa; __ Mastercard; __ American Express Discover

Account No:

Exp Date:

Signature:

__________________________________________

DESCRIPTION	QTY	TYPE/MATTED OR MOUNTED SIZE	PRICE UNFRAMED	TOTAL

AMOUNT OF ORDER

prints up to 16x20 size are $8.shipping for 1-2 prints

prints over 16x20 up to14x26 are $12. shipping

larger than 14x26 are $20-30.

call for more info 304-258-2482

SHIPPING & HANDLING

8.00-20.00

art@jheath.com

SUBTOTAL

WV Residents add 6% Sales Tax

TOTAL ORDER

Name:		Date:
Address:
City, State, ZIP:		Phone:
Credit Card:	__ Visa; __ Mastercard; __ American Express Discover
Account No:		Exp Date:
Signature:	__________________________________________

		AMOUNT OF ORDER
	prints up to 16x20 size are $8.shipping for 1-2 prints prints over 16x20 up to14x26 are $12. shipping larger than 14x26 are $20-30. call for more info 304-258-2482	SHIPPING & HANDLING	8.00-20.00
art@jheath.com		SUBTOTAL
		WV Residents add 6% Sales Tax
		TOTAL ORDER