Artistic Mementos - Order Form

ORDER FORM - ONE ARTISTIC MEMENTO ONLY

TO BE SUPPLIED ON STRETCH-FRAME CANVAS

I wish to order the creation of an artistic memento from the photograph that I will submit in due course. (Please wait for Artistic Mementos.com to reply. You will be told an e-mail address to which you will send digital photo file or a postal address to which you will send photographic print):

My Name
My email address
Contact Phone Number (include country code)

Please send my Artistic Memento to this Address: (please include country and postcode)

Only one artwork project can be specified in this order, though multiple copies can be ordered.

Number of copies The photograph will be provided as:

Notes
Note any issue such as cropping requirement, or unusual image source:

Specifications for the finished artwork:

Width (inches) Depth (inches)

Please refer to size-price table

Credit card details are required before work can proceed on your project. Please provide these below.
Credit card transactions will not be actioned until we are satisfied the project is feasible.

Credit card type:
Credit card number

Expiry date

Name on credit card:

Please state amount being paid.

FAX SECURITY OPTION: Print this out and fax to +64-4-472 9616