The Loaded Brush Order Form
Contact Us
(618) 224-7704
1-800-245-7505

Please provide the following contact information:

First Name
Last Name
Title
Organization
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Please provide the following product information:
 

CHOICE #1	Canvas 22x28 Framed - $300.00 Canvas Print Only - $200.00 10 x 13 Archival Print - Framed $150.00 10 x 13 Print Only - $50.00 Archival Print 8 x 10 only - $15.00
Print  Name
Quantity	Shipping charges and tax included in price.

CHOICE #2	Canvas 22x28 Framed - $300.00 Canvas Print Only - $200.00 10 x 13 Archival Print - Framed $150.00 10 x 13 Print Only - $50.00 Archival Print 8 x 10 only - $15.00
Print  Name
Quantity	Shipping charges and tax included in price.

 

CHOICE #3	Canvas 22x28 Framed - $300.00 Canvas Print Only - $200.00 10 x 13 Archival Print - Framed $150.00 10 x 13 Print Only - $50.00 Archival Print 8 x 10 only - $15.00
Print  Name
Quantity	Shipping charges and tax included in price.

 

BILLING- If left blank, we will assume to use the address above.

	SHIPPING
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	How will you be paying?
	MasterCard  Visa  Money OrderCheck If paying by credit card, please call M-F 8am-4:30pm CST.  1-800-245-7505   Comments or Questions?