|
PERSONAL INFORMATION
Your full name:___________________________________________________
Street
Address:____________________________________________________
City:_____________________________________________________________
Country:_______________________________
Postal Code:____________________________
Phone: (______)________________ Fax: (______)______________
E-mail:_________________________________________________________
PAINTING INFORMATION
Painting Category
Number (ie BA 9 for Baffin #9)_________________________
Painting Title:______________________________________________________
What
is it you request (Original, Photo, or Reproduction Print - circle what
applies below)
[You may preview a far superior image to what you see on the Website
of most of the paintings by ordering a 8"x 10" color photo for No Charge].
- ORIGINAL
- PRINT
Image Size:________________________________________________________
Price: ____________________$Cdn
Description-
use this area to describe the painting if you are unable to fill in the
above information:
__________________________________________________________________
__________________________________________________________________
PAYMENT INFORMATION
All Sales are subject to 5% GST within
Canada and 7.0% PST within British Columbia.
Please be sure to add this onto any purchases you are making.
Please make payable to Fine Art Marketing
Services
CREDIT CARD- VISA
and MASTERCARD ONLY
CREDIT CARD DETAILS:
Credit Card type (ie
Visa):_______________________
Credit card Customer Service phone number (on back of card):_________________
Print Cardholder Name:_______________________________________
Card Number:_______________________________________________
Card Expiration Date:_________________________________________
Address to which your credit card statement is mailed:
_____________________________
_____________________________
_____________________________
Total Amount
of purchase (please add 7% PST and 5% GST where applicable):$____________Cdn
I declare that
I am the Cardholder above and my signature authorizes payment for the
above amount:
Signed:_________________________________________________________
FAX
ORDERS:
Once this information is completed, fax this form and credit card info
(and cheque if applicable payable to Fine
Art Marketing Services) to:
Fine Art Marketing Services c/o Donald Flather.com
Fax: 604-682-4596.
MAIL ORDERS:
For those mailing in payment/ orders, please mail to:
Fine Art Marketing Services c/o Donald Flather.com
276 B.
East Esplanade Ave. (Lane)
North Vancouver, BC V7L 1A3
Please
allow 2-4 weeks for delivery. A receipt will be sent to you.
Thank-you
for supporting the artwork of Donald Flather and the charities we help
support.
|