Your Billing Address:	Shipping Address:___Business___Residence
Name________________________________	Name_______________________________
Address______________________________	Address______________________________
City_______________State___Zip_________	City_______________State___Zip_________
Phone (___)____________________________	Phone (___)____________________________
Email Address__________________________	Email Address__________________________

Please Note:  Phone orders are taken During Regular Business Hours 10:00 a.m. - 7:00 p.m. CST Time.
Please Note: Orders sent by Fax are Credit Card orders only - Please include all Credit Card information.
Method of Payment:  ___ Check ___ Money Order ___ Master Card ___ VISA
Credit Card Number:_________________________Exp.Date_________
Signature___________________________________
Name as it appears on Credit Card___________________________________
***Foreign and Canadian Customers: U.S. Funds Only (Postal Money Order or Credit Card Information)

Qty	Item #	Description of Item	Price Each	Total

Please include Email Address for an Online Order Confirmation and Shipping Charges! 

Shipping & Handling Charges:  Packing, postage & insured delivery to each destination in the Continental U.S.A: 20% of Sale Foreign Order Surcharge: Surface.....Add 35% to Sale Air............Add 40% to Sale	Subtotal of Artwork	$
	Shipping & Handling (see chart)	$
	Total	$
	WI residents add 5.5% State Tax	$
	Final Total	$

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