Ordering Instructions: Please print out and complete this form. Payment by check (made payable to "Custom Impressions"), money order, or Visa or Mastercard.

1. Indicate number of pages desired. Minimum order is 25 pages.
2. Select desired painter or painters from list.
3. Price schedule:

4. Shipping: (U.S.A. orders only) $3.50 for up to 50 pages; $5.00 for up to 125 pages; $6.50 for up to 250 pages. Add additional shipping for larger quantities. Foreign orders please add 20%.
5. Mail or fax your form and payment to us: Custom Impressions, P.O. Box 2286, La Grange, IL 60525-8386, U.S.A. Phone: (708) 579-1447; Fax: (708) 579-1473.
 

No. of  Pages	Painter	Price	Total
		$      .	$      .
		$      .	$      .
		$      .	$      .
		$      .	$      .
		$      .	$      .
	Sub-Total		$      .
	7-3/4% IL Sales Tax		$      .
	Shipping (minimum $3.50 per order)		$      .
	Total Enclosed		$      .

 
Credit Card Information:

Visa	Number:	Exp. Date:    /
Mastercard	Number:	Exp. Date:    /

Shipping Address:

Name:
Address:
City/State/Zip:
Country: