
MAIL ORDER FORM

Please print out & send check or money order to:

"Lotus Land" - Giclée Print 17x24 image size 21x28 paper size $150 each
Quantity _______
Total: $_______
(US shipping, handling and tax included, allow 4 to 6 weeks delivery)
(for International shipping we will contact you with charges)
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Date ___________
Name ______________________________________________
Company Name ______________________________________________
Address ______________________________________________
City, State, Zip ______________________________________________
Telephone ______________________________________________
Fax ______________________________________________
email ______________________________________
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