|
Please use this form only if you do NOT want to pay by credit card. |
| Please print out
and complete this form
and mail it with a Money Order (sorry, we cannot accept checks at this time) for the full amount to: |
|
A Small Work of ArtŪ, 863 Gehrke Road, Port Angeles, WA 98362-8451
|
| Name:
__________________________________________________________
Street Address:___________________________________________________ City:__________________________________ State:_____ Zip:____________ |
| Important:
Daytime Phone:___________________________________________________ Evening
Phone:___________________________________________________ |
| SHIP TO information (if
different):
Name: __________________________________________________________ Street Address:___________________________________________________ City:__________________________________ State:_____
Zip:____________ |