Order Form
To place an order, please print out the form below and
mail it to:
Sulkowski Fine Art
65 West Pike Street
Canonsburg, Pa. 15317
Name: |
____________________________________________________________ | ||
Address: |
____________________________________________________________
____________________________________________________________ |
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City: |
____________________________________________________________ | ||
State: |
____________________________________________________________ | ||
ZipCode: |
____________________________________________________________ | ||
Phone Number: |
____________________________________________________________ | ||
Painting(s)/Print(s) Desired: |
____________________________________________________________ ____________________________________________________________ ____________________________________________________________ | ||
Quantity (for Prints only): |
_________________ @ $_______________ each = $_______________ | ||
Amount Enclosed: |
____________________________________(Pa. Residents Add 6% Sales Tax) | ||
Payment Method (Check One): |
Check___ Charge___ Money Order___ |
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If Charge, Check One: |
Mastercard_____________ Visa_____________ |
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Credit Card Number: |
___________________________________________________________ Exp. Date:____________ |
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Special Instructions or Comments: |
____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ | ||
Signature:_______________________________________________
***Required for Charge Orders***
Enclose your check or money order made payable to: James M. Sulkowski
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